Provider Demographics
NPI:1467841999
Name:MADILL, JONATHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:MADILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 HAMILTON PL
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-7917
Mailing Address - Country:US
Mailing Address - Phone:423-707-2509
Mailing Address - Fax:423-379-1210
Practice Address - Street 1:1041 HAMILTON PL
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-7917
Practice Address - Country:US
Practice Address - Phone:423-707-2509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2835111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor