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NPI Code Detail

MEDICARE: DR. ELMER C MAGGARD PH.D.

MEDICARE: DR. ELMER C MAGGARD PH.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
1103TC0700XClinical Psychologist129645KY

General Provider Information

NPI Number : 1528281565
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELMER C MAGGARD PH.D.
Provider Business Mailing Address
First Line : 427 W JEFFERSON ST
Second Line :
City : PADUCAH
State : KY
Zip : 42001-4336
Country : US
Telephone Number : 859-489-7384
Fax Number :
Provider Business Practice Location Address
First Line : 2500 HOLT RD
Second Line :
City : PADUCAH
State : KY
Zip : 42001-8661
Country : US
Telephone Number : 869-489-7384
Fax Number : 270-558-3257
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 09/19/2018

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