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 M.D. (SUPERINTENDENT MEDICAL DIRECTOR)
(812) 265-2611
Entity
Organization
Contact information
Practice address
711 GREEN RD, MADISON, IN 47250-2143
(812) 265-2611
Mailing address
711 GREEN RD, MADISON, IN 47250-2143
(812) 265-2611
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
STATE OWNED
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100273320A
—
IN
Enumeration date
10/26/2005
Last updated
02/02/2010
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