Organization
LK MADISON MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS KEITH MADISON M.D. (SOLE MEMBER/OWNER/PHYSICIAN)
(641) 872-2260
Entity
Organization
Contact information
Practice address
417 S EAST ST, CORYDON, IA 50060-1860
(641) 872-2260
(641) 872-3656
Mailing address
2213 GRAND AVE, DES MOINES, IA 50312-5305
(515) 237-3974
(515) 883-2692
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
33436
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IN PROCESS
—
IA
Enumeration date
09/17/2012
Last updated
09/17/2012
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