MARLO MADDOX-KLECKLEY (NPI# 1275557175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275557175 |
| Entity Type | Individual |
| Full Name | MARLO MADDOX-KLECKLEY |
| Credential | M.D. |
| Practice Address |
2795 E Bidwell St # 100-189 Folsom CA 95630-6405 |
| Mailing Address |
11000 Olson Dr Suite 100 Rancho Cordova CA 95670-5653 |
| Practice Telephone | 9166354120 |
| Practice Fax Number | 9164633084 |
| Mailing Telephone | 9166354120 |
| Mailing Fax Number | 9164633084 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A80427 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2795 E BIDWELL ST # 100-189 |
| City | FOLSOM |
| State | CA |
| Zip Code | 95630-6405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831724657 | Corrections and Rehabilitation | Pharmacy | 570 E. Natoma Street, Folsom, CA 95630 | 2020-03-12 |
| 1174153027 | Haley Harmon | Nurse Practitioner | 1621 Creekside Dr. Creekside Ob/gyn, Ste. 102, Folsom, CA 95630 | 2020-01-20 |
| 1932741469 | Ruma Ramani Jolly | Speech-Language Pathologist | 250 Mc Adoo Drive, Willow Springs, Apt.911, Folsom, CA 95630 | 2019-10-16 |
| 1750844767 | Sharon Munyaanyi | Registered Nurse | 1600 Creekside Dr Ste 3700, Folsom, CA 95630 | 2019-04-08 |
| 1104308345 | Stephanie Whatley | Optometrist | 2390 E Bidwell St Ste 400, Folsom, CA 95630 | 2018-09-04 |
| 1447746607 | Heather Michellee Thrapp | Behavioral Analyst | 125 Oak Ravine Way, Folsom, CA 95630 | 2018-07-10 |
| 1700370483 | Loretta May Delgado | Behavior Technician | 322 Crow Cany, Folsom, CA 95630 | 2018-06-18 |
| 1417448176 | Sound Support Inc. | Hearing Instrument Specialist | 610 East Bidwell Street, Suite A, Folsom, CA 95630 | 2018-05-29 |
| 1548750144 | Don Peterson Md, Sugical Assisting | General Practice | Mercy Hospital of Folsom (dignity Health Folsom), 1650 Creekside Dr., Folsom, CA 95630 | 2018-05-18 |
| 1245733328 | American Heritage Hospice Inc | Hospice Care, Community Based | 1837 Iron Point Rd Ste 180, Folsom, CA 95630 | 2018-03-14 |
| Find all providers in zip 95630 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326550237 | Robert Julian Segura Jr. | Family Medicine | 13242 Finley Rd., Folsom, LA 70437 | 2017-11-01 |
| 1134523814 | Simin Kharazi | Family Medicine | 1710 Prairie City Rd Ste 120, Folsom, CA 95630-9592 | 2014-10-09 |
| 1184065930 | Jessica Lauren Wall | Family Medicine | 2575 E Bidwell St Ste 250, Folsom, CA 95630-6447 | 2013-07-09 |
| 1639513823 | Ann Duncan | Family Medicine | 2575 East Bidwell St, Ste 100, Folsom, CA 95630 | 2013-04-18 |
| 1316206071 | Gina Tobalina Md Inc | Family Medicine | 2545 East Bidwell St, Suite 110, Folsom, CA 95630-6443 | 2012-05-15 |
| 1306079660 | Eleonor Loyola Griffith | Family Medicine | 1611 Creekside Dr Ste 101, Folsom, CA 95630-3490 | 2009-09-02 |
| 1902087422 | Vicentekuo Chee Quan | Family Medicine | 101 Heart Butte Ct, Folsom, CA 95630 | 2007-11-27 |
| 1376756833 | Gina Tobalina | Family Medicine | 2545 E Bidwell St Ste 110, Folsom, CA 95630-6443 | 2007-05-08 |
| 1073614350 | Joanna Hoang Nguyen | Family Medicine | 1641 Creekside Dr Ste 201, Folsom, CA 95630-3831 | 2006-09-26 |
| 1487676656 | Glenn W Thiel | Family Medicine | 1710 Prairie City Rd Ste 125, Folsom, CA 95630-4042 | 2006-07-24 |
| Find all providers in FOLSOM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.