# J MADISON CLARK MD PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043620347
- **Authorized official:** SONJA D THOMPSON (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (336) 538-1966

## Contact information

- **Practice address:** 1248 HUFFMAN MILL RD, SUITE 201, BURLINGTON, NC 27215-8700
- **Practice address phone:** (336) 538-1966
- **Practice address fax:** (336) 538-1729
- **Mailing address:** PO BOX 24848, WINSTON SALEM, NC 27114-4848
- **Mailing address phone:** (336) 538-1966
- **Mailing address fax:** (336) 538-1729

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | 9700217 | NC | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 9700217 | NC | — |

## Other

- **Enumeration date:** 05/07/2014
- **Last updated:** 07/23/2014