Madson, Derald L.

Madson, Derald L. is an individual health care provider with primary practice located at 3964 Frazeysburg Rd , Zanesville OH 43701-8924. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Madson, Derald L. can be contacted via phone (740) 455-4944.

Contact Information

Primary practice address
3964 Frazeysburg Rd Zanesville OH 43701-8924
Phone: (740) 455-4944
Fax: (740) 450-6199
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 35059388 Ohio

Profile Details

NPI number 1598769077
LBN Legal business name Madson, Derald L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Apr 2nd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598769077 NPPES
Ohio Other 311661239026 CARESOURCE
Ohio Other 000000122822 CARESOURCE
Ohio MEDICAID 2131955 CARESOURCE

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