D. Maddox, M.D., a Prof. Corp

Primary specialty

SpecialistTaxonomy code 174400000X

License

G24697 Issued in CA

Legal business name

D. MADDOX, M.D., A PROF. CORP

Practice address

2901 Sillect Ave Ste 200
Bakersfield, CA 93308-6370

Phone

(661) 326-1100

NPI assigned

Aug 24, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Denis Eric Maddox, M.D.

Title

President

Phone

(661) 326-1100

Specialties & licenses 1

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240185600000",
    "number": "1174716997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 SILLECT AVE STE 200",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933086370",
            "telephone_number": "661-326-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 SILLECT AVE STE 200",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933086370",
            "telephone_number": "661-326-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D. MADDOX, M.D., A PROF. CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "last_updated": "2009-04-20",
        "status": "A",
        "authorized_official_last_name": "MADDOX",
        "authorized_official_first_name": "DENIS",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-326-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G24697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP RAILROAD",
            "identifier": "DN8120",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ05742Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G246970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.