MEDICARE: BRIAN N. MADDUX MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	41984	KY
2	2084N0400X	Neurology Physician	35-072754	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01213793	OTHER	KY	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	2442321	OTHER	OH	AETNA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	000000510678	OTHER	OH	ANTHEM
7	221373	OTHER	OH	UNISON

General Provider Information

NPI Number	:	1649298001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN N. MADDUX MD

Provider Business Mailing Address
First Line	:	4805 MONTGOMERY RD
Second Line	:	SUITE 150
City	:	CINCINNATI
State	:	OH
Zip	:	45212-2198
Country	:	US
Telephone Number	:	513-961-5558
Fax Number	:	513-961-1912

Provider Business Practice Location Address
First Line	:	4805 MONTGOMERY RD STE 210
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-2280
Country	:	US
Telephone Number	:	513-241-2370
Fax Number	:	513-241-6053

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	11/15/2024

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Directions to “ BRIAN N. MADDUX MD” Practice Location

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