Provider Demographics
NPI:1477501823
Name:MADIGAN, JOHN C JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:MADIGAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 LANTERN LN
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4049
Mailing Address - Country:US
Mailing Address - Phone:860-721-0155
Mailing Address - Fax:860-513-1535
Practice Address - Street 1:119 LANTERN LN
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-4049
Practice Address - Country:US
Practice Address - Phone:860-721-0155
Practice Address - Fax:860-513-1535
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2012-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT021028207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology