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General NPI Number Information
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NPI Number | 1053127464
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Entity Type | Individual
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Provider Name | MADISON MCKAY PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 3200 MACCORKLE AVE SE
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City | CHARLESTON
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State | WV
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Zip | 25304-1227
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Country | US
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Telephone | 304-388-4172
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Fax |
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Provider Business Mailing Address
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Address Line | 102 STRATFORD PL
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City | CHARLESTON
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State | WV
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Zip | 25303-2819
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Country | US
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Telephone | 352-467-4427
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9119381
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2958
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License Number State | WV
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