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General NPI Number Information
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NPI Number | 1275553976
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Entity Type | Individual
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Provider Name | JAMES FRANKLIN MADISON PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 11/18/2011
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Provider Practice Location Address
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Address Line | 4802 S 109TH EAST AVE
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City | TULSA
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State | OK
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Zip | 74146-5822
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Country | US
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Telephone | 918-236-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 3211 JEANNIE LN
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City | MUSKOGEE
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State | OK
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Zip | 74403-7775
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Country | US
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Telephone | 918-360-7603
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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 | PA463
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License Number State | OK
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