Provider Demographics
NPI:1073500401
Name:MADELEY, JAMES B (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:MADELEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2680 LAWRENCEVILLE HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2526
Mailing Address - Country:US
Mailing Address - Phone:770-491-3003
Mailing Address - Fax:770-491-0729
Practice Address - Street 1:2680 LAWRENCEVILLE HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-2526
Practice Address - Country:US
Practice Address - Phone:770-491-3003
Practice Address - Fax:770-491-0729
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA018403207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00181772Medicaid
GA20BBDPPMedicare ID - Type Unspecified
GA00181772Medicaid