Healthcare Provider Details

I. General information

NPI: 1922654326
Provider Name (Legal Business Name): MADISON E FERRELL DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MADISON ALEXANDER DPT

II. Dates (important events)

Enumeration Date: 08/13/2019
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6038 MIDWAY AVE
ALEXANDER AR
72002-7056
US

IV. Provider business mailing address

10014 NORTH RODNEY PARHAM SUITE 103
LITTLE ROCK AR
72227
US

V. Phone/Fax

Practice location:
  • Phone: 817-983-3949
  • Fax:
Mailing address:
  • Phone: 501-224-5454
  • Fax: 501-224-5460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4639
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP058026T
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP058061T
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP057913T
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP057867T
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP057866T
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: