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General NPI Number Information
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NPI Number | 1528122256
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Entity Type | Individual
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Provider Name | JOHN SPECHT MADDOX MD
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | WALTER REED NATIONAL MILITARY CTR 8901 WISCONSIN AVE
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City | BETHESDA
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State | MD
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Zip | 20889-0001
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Country | US
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Telephone | 301-400-2201
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Fax |
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Provider Business Mailing Address
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Address Line | 3823 RODMAN ST NW APT E23
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City | WASHINGTON
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State | DC
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Zip | 20016-2816
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Country | US
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Telephone | 240-506-6532
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | D0089752
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | D0089752
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License Number State | MD
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