Organization
STATE OF INDIANA, AUDITOR OF STATE
Active
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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