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Contact Information

BRUCE R MADDERN, MD
10475 CENTURION PKWY N
SUITE 302
JACKSONVILLE, FL32256-5003
 Phone: 904-398-5437
 Fax: 904-398-3077
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Otolaryngology

207YP0228X 04 Physician/Otolaryngology
 

Otolaryngology/Facial Plastic Surgery

207YX0905X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for BRUCE R MADDERN · (Male)

NPI # 1528030418
Status Active
Credentials MD
Entity Individual
Enumeration date 02/03/2006
Last updated 06/25/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME0056292
  • FL Medicaid 061886100
  • FL Other 2218700 AETNA
  • FL Other 203211 AV MED
  • FL Other 08675 BCBS
  • FL Other 0205114006 CIGNA
  • FL Other 12056336 MULTIPLAN
  • FL Other P2759499 OXFORD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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