Healthcare Provider Details

I. General information

NPI: 1003733155
Provider Name (Legal Business Name): MADISON TAYLOR LAMPRECHT HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 TARRYTOWN CTR
ROCKY MOUNT NC
27804-1780
US

IV. Provider business mailing address

300 TARRYTOWN CTR
ROCKY MOUNT NC
27804-1780
US

V. Phone/Fax

Practice location:
  • Phone: 252-443-4044
  • Fax:
Mailing address:
  • Phone: 252-443-4044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1703
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: