Basic Information
| Provider Information | |||||||||
| NPI: | 1710017686 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MADDEN | ||||||||
| FirstName: | HERVEY | ||||||||
| MiddleName: | MAC | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25 GAP RD | ||||||||
| Address2: | |||||||||
| City: | BATESVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 725018679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707938900 | ||||||||
| FaxNumber: | 8707938959 | ||||||||
| Practice Location | |||||||||
| Address1: | 3302 E MOORE AVE | ||||||||
| Address2: | |||||||||
| City: | SEARCY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721434886 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012684181 | ||||||||
| FaxNumber: | 5012685301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2007 | ||||||||
| LastUpdateDate: | 07/08/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 27024 | SC | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.