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NPI Code Detail

MEDICARE: MADISON STREET PROVIDER NETWORK INC

MEDICARE: MADISON STREET PROVIDER NETWORK INC
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
1152W00000XOptometristCO
2207W00000XOphthalmology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699768663
Entity Type Code : Organization
Provider Name (Legal Business Name) : MADISON STREET PROVIDER NETWORK INC
Provider Business Mailing Address
First Line : 55 MADISON ST STE 355
Second Line :
City : DENVER
State : CO
Zip : 80206-5429
Country : US
Telephone Number : 303-377-2020
Fax Number : 303-377-2022
Provider Business Practice Location Address
First Line : 55 MADISON ST STE 355
Second Line :
City : DENVER
State : CO
Zip : 80206-5429
Country : US
Telephone Number : 303-377-2020
Fax Number : 303-377-2022
Authorized Official
Title or Position : PRESIDENT & SECRETARY
Name : GEORGE L NEAL
Credential :
Telephone Number : 469-214-0144
Provider Enumeration Date : 08/25/2005
Last Update Date : 10/15/2020

Similar Medicare Providers

1992741961 — EUGENE O WIGGS M.D.
Practice Location Address:
55 MADISON ST STE 355
DENVER, CO
80206-5429
Practice Phone: 303-377-2020
Practice Fax:
1003101627 — MS. KIOK CHO ANP-BC
Practice Location Address:
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80206-5429
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Practice Fax:
1154785863 — DR. MARIANA HARASAWA MD
Practice Location Address:
55 MADISON ST STE 355
DENVER, CO
80206-5429
Practice Phone: 303-377-2020
Practice Fax:
1053833681 — BETTY BOCONG ZHANG OD
Practice Location Address:
55 MADISON ST STE 355
DENVER, CO
80206-5429
Practice Phone: 303-377-2020
Practice Fax:
1285278341 — THERESA NGOC HOANG OD
Practice Location Address:
55 MADISON ST STE 355
DENVER, CO
80206-5429
Practice Phone: 303-377-2020
Practice Fax:
1386271443 — JAMES DOWGIN OD
Practice Location Address:
55 MADISON ST STE 355
DENVER, CO
80206-5429
Practice Phone: 303-377-2020
Practice Fax: 303-377-2022

Directions to “MADISON STREET PROVIDER NETWORK INC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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