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General NPI Number Information
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NPI Number | 1427171073
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Entity Type | Organization
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Legal Business Name | JOHN R MADISON MD, INC
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | 2094 E STATE ST STE D
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City | SALEM
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State | OH
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Zip | 44460-4409
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Country | US
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Telephone | 330-337-7316
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Fax | 330-337-1765
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Provider Business Mailing Address
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Address Line | 2094 E STATE ST STE D
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City | SALEM
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State | OH
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Zip | 44460-4409
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Country | US
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Telephone | 330-337-7316
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Fax | 330-337-1765
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN R MADISON
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Credential | MD
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Telephone | 330-337-7316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | OH
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