Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | RT000472 | GA |
N | 111NI0900X | Internist | RT000472 | GA |
N | 207RC0000X | Internist - Cardiovascular Disease | 059550 | GA |
N | 207RC0000X | Internist - Cardiovascular Disease | 30758 | AL |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 30758 | AL |
NPI | 1003030693 |
---|---|
Provider Name | Dr. William Randolph Maddox |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35211-1303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 07/04/2016 |