MEDICARE: MADISON FISH

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	171100000X	Acupuncturist	2527	NV

General Provider Information

NPI Number	:	1760336663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON FISH

Provider Business Mailing Address
First Line	:	5882 STONEBOROUGH ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-1736
Country	:	US
Telephone Number	:	408-420-9679
Fax Number	:

Provider Business Practice Location Address
First Line	:	8630 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2836
Country	:	US
Telephone Number	:	702-852-1280
Fax Number	:

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

Provider Enumeration Date	:	02/26/2026
Last Update Date	:	02/26/2026

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Directions to “ MADISON FISH ” Practice Location

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