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NPI Code Detail

MEDICARE: MADISON NEGRIN RBT

MEDICARE: MADISON NEGRIN RBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-24-332430AZ

General Provider Information

NPI Number : 1639928203
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON NEGRIN RBT
Provider Business Mailing Address
First Line : 414 S LINWOOD ST
Second Line :
City : CORDELL
State : OK
Zip : 73632-5826
Country : US
Telephone Number : 480-319-3968
Fax Number :
Provider Business Practice Location Address
First Line : 1023 W 3RD ST
Second Line :
City : ELK CITY
State : OK
Zip : 73644-5200
Country : US
Telephone Number : 405-394-1279
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2024
Last Update Date : 07/29/2025

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Directions to “ MADISON NEGRIN RBT” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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