Provider Demographics
NPI:1336208610
Name:MADISON FAMILY MEDICINE,LLP
Entity Type:Organization
Organization Name:MADISON FAMILY MEDICINE,LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:C
Authorized Official - Last Name:PHILIPPI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-342-1555
Mailing Address - Street 1:1010 BARCLAY DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:GA
Mailing Address - Zip Code:30650-4621
Mailing Address - Country:US
Mailing Address - Phone:706-342-1555
Mailing Address - Fax:706-342-3917
Practice Address - Street 1:1010 BARCLAY DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:GA
Practice Address - Zip Code:30650-4621
Practice Address - Country:US
Practice Address - Phone:706-342-1555
Practice Address - Fax:706-342-3917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty