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General NPI Number Information
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NPI Number | 1578501540
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Entity Type | Individual
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Provider Name | LEAH MADSEN MD
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Gender | Female
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 4211 JOE RAMSEY BLVD E SUITE 100
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City | GREENVILLE
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State | TX
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Zip | 75401-7852
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Country | US
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Telephone | 903-408-7750
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Fax | 903-408-7802
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Provider Business Mailing Address
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Address Line | PO BOX 957
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City | GREENVILLE
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State | TX
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Zip | 75403-0957
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Country | US
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Telephone | 903-408-7750
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Fax | 903-408-7802
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K5343
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License Number State | TX
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