| Madison Physician Group Inc | |
|
379 Hospital Blvd Jackson TN 38305-2080 | |
| (731) 661-6330 | |
| Not Available |
| Full Name | Madison Physician Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 379 Hospital Blvd, Jackson, Tennessee |
| Authorized Official Name and Position | Ashley Scott Brewer (OWNER) |
| Authorized Official Contact | 9313086335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Physician Group Inc 340 Waynick Rd Jackson TN 38305-9166 Ph: (931) 308-6335 | Madison Physician Group Inc 379 Hospital Blvd Jackson TN 38305-2080 Ph: (731) 661-6330 |
| NPI Number | 1770256836 |
|---|---|
| Provider Enumeration Date | 07/26/2021 |
| Last Update Date | 07/01/2025 |
| Certification Date | 07/01/2025 |
| Medicare PECOS PAC ID | 5496153249 |
|---|---|
| Medicare Enrollment ID | O20250718000835 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770256836 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | () | Primary |
| Provider Name | Ashley Scott Brewer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417086547 PECOS PAC ID: 0143373522 Enrollment ID: I20090803000268 |
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