Organization
STATE OF INDIANA, AUDITOR OF STATE
Active
Other names
MADISON STATE HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PEGGY S STEPHENS MD (SUPERINTENDANT AND MEDICAL DIRECTOR)
(812) 265-2611
Entity
Organization
Contact information
Practice address
711 GREEN RD, MADISON, IN 47250-2143
(812) 265-2611
(812) 265-7227
Mailing address
711 GREEN RD, MADISON, IN 47250-2143
(812) 265-2611
(812) 265-7227
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
941750
MEDICARE B
—
01
—
PROFESSIONAL COMP
GROUP
IN
Enumeration date
03/22/2007
Last updated
12/17/2007
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