Austin John Maddy, | |
1025 Maine St, Quincy, IL 62301-4096 | |
(217) 222-6550 | |
Not Available |
Full Name | Austin John Maddy |
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Gender | Male |
Speciality | Dermatology |
Location | 1025 Maine St, Quincy, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578023362 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | 036174529 (Illinois) | Primary |
Entity Name | Genesis Health System |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1528616901 PECOS PAC ID: 6103829338 Enrollment ID: O20191031002622 |
Mailing Address | Practice Location Address |
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Austin John Maddy, 1025 Maine St, Quincy, IL 62301-4096 Ph: (217) 222-6550 | Austin John Maddy, 1025 Maine St, Quincy, IL 62301-4096 Ph: (217) 222-6550 |
Elise Scoggin, D.O. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1132 Broadway St, Quincy, IL 62301 Phone: 217-214-6250 Fax: 217-385-3850 | |
Anna Levin, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1025 Maine St, Quincy, IL 62301 Phone: 217-222-6550 | |
Dr. Sumul Ashok Gandhi, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1025 Maine St, Quincy, IL 62301 Phone: 217-222-6550 |