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General NPI Number Information
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NPI Number | 1952876310
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Entity Type | Individual
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Provider Name | THOMAS MADIGAN
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Gender | Male
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Dates
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Enumeration Date | 10/11/2018
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Last Update Date | 11/12/2018
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Provider Practice Location Address
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Address Line | 1800 MULBERRY ST
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City | SCRANTON
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State | PA
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Zip | 18510-2369
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Country | US
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Telephone | 570-703-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 398 S MEADE ST
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City | WILKES BARRE
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State | PA
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Zip | 18702-6250
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Country | US
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Telephone |
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | MA060248
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License Number State | PA
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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 | MA060248
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License Number State | PA
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