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Contact Information

KURT A MADDOCK, MD
2 S HOSPITAL DR
MURPHYSBORO, IL62966-3333
 Phone: 618-684-1035
 Fax: 618-684-1036
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Undersea and Hyperbaric Medicine

2083P0011X 84 Physician/Preventive Medicine
 

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for KURT A MADDOCK · (Male)

NPI Number 1740253707
Status Active
Credentials MD
Entity Individual
Enumeration date 02/09/2006
Last updated 08/03/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036.144660
  • IL License # 036144660
  • IN License # 01038293A
  • IN Medicaid 100318820A
  • IN Other 000000599251 ANTHEM
  • IN Other P00658239 RAILROAD MEDICARE
Hospital affiliation(s)
  • HERRIN HOSPITAL - (Acute Care)
    201 S 14TH ST
    HERRIN, IL 62948
  • ST JOSEPH MEMORIAL HOSPITAL - (Critical Access)
    2 SOUTH HOSPITAL DRIVE
    MURPHYSBORO, IL 62966
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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