Provider Demographics
NPI:1851380893
Name:MADIGAN, MERLE N (DO)
Entity Type:Individual
Prefix:
First Name:MERLE
Middle Name:N
Last Name:MADIGAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 ALEXANDER DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-3003
Mailing Address - Country:US
Mailing Address - Phone:334-671-1696
Mailing Address - Fax:334-794-0721
Practice Address - Street 1:1108 ROSS CLARK CIR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3022
Practice Address - Country:US
Practice Address - Phone:334-671-1696
Practice Address - Fax:334-794-0721
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO-881207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051555489Medicaid
AL051555489Medicaid
ALH71175Medicare UPIN