Provider Demographics
NPI:1578129177
Name:MADISON HMA LLC
Entity Type:Organization
Organization Name:MADISON HMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP PHYSICIAN BUSINESS SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-778-1502
Mailing Address - Street 1:161 RIVER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-5375
Mailing Address - Country:US
Mailing Address - Phone:601-855-4011
Mailing Address - Fax:601-936-3116
Practice Address - Street 1:161 RIVER OAKS DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-5375
Practice Address - Country:US
Practice Address - Phone:601-855-4011
Practice Address - Fax:601-936-3116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-20
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty