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Contact Information

BRUCE R MADDERN MD PA
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 MD PA

NPI # 1225001589
LBN Legal business name BRUCE R MADDERN MD PA
Authorized official BRUCE MADDERN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 02/08/2006
Last updated 09/07/2007 - About 19 years ago
Identifiers
Other 45553 BC/BS OF FL
FL Other 8651 AV MED
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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