Provider Demographics
NPI:1831220193
Name:MADISON MEDICAL SERVICES
Entity type:Organization
Organization Name:MADISON MEDICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAFRON
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:DUCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-755-0069
Mailing Address - Street 1:103 HICKORY GLEN CIRCLE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811
Mailing Address - Country:US
Mailing Address - Phone:256-755-0069
Mailing Address - Fax:256-776-0504
Practice Address - Street 1:103 HICKORY GLEN CIRCLE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35811
Practice Address - Country:US
Practice Address - Phone:256-755-0069
Practice Address - Fax:256-776-0504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic