| Edward Madison Iii, L.l.c | |
|
9511 Chef Menteur Suite 114 New Orleans LA 70127-4231 | |
| (504) 241-0861 | |
| (504) 241-0850 |
| Full Name | Edward Madison Iii, L.l.c |
|---|---|
| Speciality | Internal Medicine |
| Location | 9511 Chef Menteur, New Orleans, Louisiana |
| Authorized Official Name and Position | Edward Madison (OWNER/MEDICAL DIRECTOR) |
| Authorized Official Contact | 5042410861 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward Madison Iii, L.l.c 9511 Chef Menteur Suite 114 New Orleans LA 70127-4231 Ph: (504) 241-0861 | Edward Madison Iii, L.l.c 9511 Chef Menteur Suite 114 New Orleans LA 70127-4231 Ph: (504) 241-0861 |
| NPI Number | 1235428616 |
|---|---|
| Provider Enumeration Date | 04/06/2011 |
| Last Update Date | 04/06/2011 |
| Medicare PECOS PAC ID | 5991989394 |
|---|---|
| Medicare Enrollment ID | O20110408000621 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235428616 | NPI | - | NPPES |
| 1480631 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 020631 (Louisiana) | Primary |
| Provider Name | Edward Madison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104956382 PECOS PAC ID: 5698807527 Enrollment ID: I20100713000294 |
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