MEDICARE: MADISON NEWSOM KOSIER PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant
2	363A00000X	Physician Assistant	0010-14395	NC

General Provider Information

NPI Number	:	1093307845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON NEWSOM KOSIER PA

Provider Business Mailing Address
First Line	:	1212 ENCLAVE CIR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-7440
Country	:	US
Telephone Number	:	865-850-8452
Fax Number	:

Provider Business Practice Location Address
First Line	:	1212 ENCLAVE CIR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-7440
Country	:	US
Telephone Number	:	865-850-8452
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2021
Last Update Date	:	04/06/2026

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Directions to “ MADISON NEWSOM KOSIER PA” Practice Location

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