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NPI Code Detail

MEDICARE: PAUL TIMOTHY MADDUX M.D.

MEDICARE: PAUL TIMOTHY MADDUX M.D.
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
1207R00000XInternal Medicine Physician36015SC
2207RI0011XInterventional Cardiology Physician87892GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063851129
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL TIMOTHY MADDUX M.D.
Provider Business Mailing Address
First Line : PO BOX 925
Second Line :
City : AUGUSTA
State : GA
Zip : 30903-0925
Country : US
Telephone Number : 706-724-8611
Fax Number : 706-724-6202
Provider Business Practice Location Address
First Line : 1348 WALTON WAY STE 5100
Second Line :
City : AUGUSTA
State : GA
Zip : 30901-5108
Country : US
Telephone Number : 706-724-8611
Fax Number : 706-724-6202
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2013
Last Update Date : 03/21/2023

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Directions to “ PAUL TIMOTHY MADDUX M.D.” Practice Location

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