MEDICARE: DR. DANIEL K MADSEN D.O.

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
1	207R00000X	Internal Medicine Physician	34-00-3920	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740265081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL K MADSEN D.O.

Provider Business Mailing Address
First Line	:	PO BOX 2018
Second Line	:
City	:	CHILLICOTHEE
State	:	OH
Zip	:	45601-8018
Country	:	US
Telephone Number	:	740-775-7943
Fax Number	:	740-947-7943

Provider Business Practice Location Address
First Line	:	13800 US RT 23 N
Second Line	:
City	:	WAVERLY
State	:	OH
Zip	:	45690
Country	:	US
Telephone Number	:	740-947-8602
Fax Number	:	740-947-7943

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	04/11/2014

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