Provider Demographics
NPI:1801075999
Name:MADDOX PAIN MANAGEMENT PC
Entity type:Organization
Organization Name:MADDOX PAIN MANAGEMENT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:GILBERT
Authorized Official - Last Name:MADDOX
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:256-237-7002
Mailing Address - Street 1:1309 QUINTARD AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36201-4619
Mailing Address - Country:US
Mailing Address - Phone:256-237-7002
Mailing Address - Fax:256-237-7673
Practice Address - Street 1:1309 QUINTARD AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-4619
Practice Address - Country:US
Practice Address - Phone:256-237-7002
Practice Address - Fax:256-237-7673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E01082Medicare UPIN
ALK387Medicare PIN