Organization
MADISON MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM LANCE MADISON RRT (PRESIDENT)
(918) 642-5310
Entity
Organization
Contact information
Practice address
115 W. MAPLE, FAIRFAX, OK 74637-1533
(918) 642-5310
(918) 642-3690
Mailing address
P.O. BOX 187, FAIRFAX, OK 74637-0187
(918) 642-5310
(918) 642-3690
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100811270A
—
OK
Enumeration date
08/30/2006
Last updated
04/19/2017
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