Individual
SPENCER J. MADELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
142 W 5TH ST, COOKEVILLE, TN 38501-1760
(931) 528-2541
(931) 526-8814
Mailing address
PO BOX 3262, INDIANAPOLIS, IN 46206-3262
(844) 257-5898
(317) 663-6054
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
31227
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38711931
—
TN
01
—
4151229
BCBS PROVIDER NUMBER
TN
01
—
P00412122
RAILROAD MEDICARE
TN
Enumeration date
01/10/2006
Last updated
02/03/2017
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