Doctor Name: | DR. GILBERT ISAAC MADISON |
NPI Number: | 1548533730 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 14245 |
Business Practice Address: | 691 Cloverdale Dr None Grand Junction, CO - 815068301 |
Business Phone Number: | 9702426545 |
Business Fax Number: | |
Mailing Address: | 691 Cloverdale Dr, None GRAND JUNCTION |
State: | CO |
Postal Code: | 815068301 |
Phone Number: | 9702426545 |
Fax Number: | |
NPI Enumeration Date: | 02/17/2012 |
NPI Last Update Date: | 02/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 14245 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |