Healthcare Provider Details

I. General information

NPI: 1922413939
Provider Name (Legal Business Name): ADAM JOSEPH MADL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2014
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 AMES ST
BALDWIN CITY KS
66006-5200
US

IV. Provider business mailing address

603 AMES ST
BALDWIN CITY KS
66006-5200
US

V. Phone/Fax

Practice location:
  • Phone: 785-594-4894
  • Fax:
Mailing address:
  • Phone: 785-594-4894
  • Fax: 785-594-2597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number05-41967
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: