Healthcare Provider Details

I. General information

NPI: 1902426588
Provider Name (Legal Business Name): MADISON LINDSEY BERMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2020
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N CAMPBELL AVE
TUCSON AZ
85719-4330
US

IV. Provider business mailing address

110 S CHURCH AVE UNIT 257
TUCSON AZ
85701-1645
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-0111
  • Fax:
Mailing address:
  • Phone: 303-345-1066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number012096
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: