Provider Demographics
NPI:1598131252
Name:THOMASON, MADISON (MS, CGC)
Entity Type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:
Last Name:THOMASON
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8615 GEORGETOWN TRACE LN
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3388
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:605 GLENWOOD DR STE 307
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1144
Practice Address - Country:US
Practice Address - Phone:423-495-2509
Practice Address - Fax:423-495-2903
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNGC 0000000043170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS