MEDICARE: MADISON CITY

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1548386485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MADISON CITY

Provider Business Mailing Address
First Line	:	211 CELTIC DR
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35758-1853
Country	:	US
Telephone Number	:	256-464-8370
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 CELTIC DR
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35758-1853
Country	:	US
Telephone Number	:	256-464-8370
Fax Number	:

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	DR. DEE FOWLER
Credential	:
Telephone Number	:	256-464-8370

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	08/22/2020

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Directions to “MADISON CITY ” Practice Location

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