Individual
DR. JAMES REGIS MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1500 E DOWNING #102, TAHLEQUAH, OK 74464
(918) 207-1189
(918) 207-1160
Mailing address
PO BOX 1008, TAHLEQUAH, OK 74465-1008
(918) 207-1189
(918) 207-1160
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4485
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200114250A
—
OK
Enumeration date
11/08/2005
Last updated
05/13/2010
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