Healthcare Provider Details

I. General information

NPI: 1831220193
Provider Name (Legal Business Name): MADISON MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 HICKORY GLEN CIRCLE
HUNTSVILLE AL
35811
US

IV. Provider business mailing address

103 HICKORY GLEN CIRCLE
HUNTSVILLE AL
35811
US

V. Phone/Fax

Practice location:
  • Phone: 256-755-0069
  • Fax: 256-776-0504
Mailing address:
  • Phone: 256-755-0069
  • Fax: 256-776-0504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. SHAFRON LAMONT DUCKETT
Title or Position: CEO
Credential:
Phone: 256-755-0069