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General NPI Number Information
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NPI Number | 1407998347
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Entity Type | Organization
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Legal Business Name | MADISON PEDIATRICS, INC.
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/14/2007
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Provider Practice Location Address
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Address Line | 55 PARK AVE. SUITE 210
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City | LONDON
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State | OH
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Zip | 43140-1121
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Country | US
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Telephone | 740-845-7720
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Fax | 740-845-7721
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Provider Business Mailing Address
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Address Line | 55 PARK AVE. SUITE 210
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City | LONDON
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State | OH
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Zip | 43140-1121
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Country | US
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Telephone | 740-845-7720
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Fax | 740-845-7721
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGG M. ALEXANDER
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Credential | D.O.
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Telephone | 740-845-7720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 34005421
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License Number State | OH
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