Healthcare Provider Details

I. General information

NPI: 1326015504
Provider Name (Legal Business Name): CHRISTOPHER K MADISON JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N MAIN ST
LONDON OH
43140-1115
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 740-845-7700
  • Fax: 740-845-7701
Mailing address:
  • Phone: 740-845-7700
  • Fax: 740-845-7701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35086377
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: