Provider Demographics
NPI:1245929843
Name:MADSON, JOEL ADAM (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ADAM
Last Name:MADSON
Suffix:
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 1:43082 VISTA RD
Mailing Address - Street 2:
Mailing Address - City:ISLE
Mailing Address - State:MN
Mailing Address - Zip Code:56342-9665
Mailing Address - Country:US
Mailing Address - Phone:320-630-8011
Mailing Address - Fax:
Practice Address - Street 1:1555 NORTHWAY DR STE 200
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4913
Practice Address - Country:US
Practice Address - Phone:320-240-3157
Practice Address - Fax:320-240-3165
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN33455207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine