MEDICARE: MADISON STACEY MD

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	390200000X	Student in an Organized Health Care Education/Training Program		IN

General Provider Information

NPI Number	:	1750224721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON STACEY MD

Provider Business Mailing Address
First Line	:	550 UNIVERSITY BLVD STE 2301
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5149
Country	:	US
Telephone Number	:	317-948-5923
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 UNIVERSITY BLVD STE 2301
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5149
Country	:	US
Telephone Number	:	317-948-5923
Fax Number	:

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

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

Similar Medicare Providers

1508709718 — DR. CADE CHRISTIAN SMELLEY MD
Practice Location Address:

550 UNIVERSITY BLVD STE 6201
INDIANAPOLIS, IN
46202-5149

Practice Phone: 317-944-9400
Practice Fax:

1124961982 — MICHAEL ALLISON DDS
Practice Location Address:

550 UNIVERSITY BLVD
INDIANAPOLIS, IN
46202-5149

Practice Phone: 317-274-5315
Practice Fax:

1932736923 — KRISTIN CHERIE FRISBY DO
Practice Location Address:

550 UNIVERSITY BLVD # 641
INDIANAPOLIS, IN
46202-5149

Practice Phone: 317-274-0010
Practice Fax:

1386586329 — TYLER NICOLE LACKLAND MD
Practice Location Address:

550 UNIVERSITY BLVD
INDIANAPOLIS, IN
46202-5149

Practice Phone: 317-944-5000
Practice Fax:

1194720003 — DR. REBECCA R SMALL MD
Practice Location Address:

550 UNIVERSITY BLVD , UH 1501
INDIANAPOLIS, IN
46202-5149

Practice Phone: 317-948-0763
Practice Fax: 317-948-0503

1104823509 — TIM E TABER III M.D.
Practice Location Address:

550 UNIVERSITY BLVD , SUITE 4620
INDIANAPOLIS, IN
46202-5149

Practice Phone: 317-948-0505
Practice Fax: 317-948-3268

Directions to “ MADISON STACEY MD” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.