DR. DERALD L. MADSON M.D. NPI 1598769077

NPI Information

NPI: 1598769077
Provider Name: DR. DERALD L. MADSON, M.D.
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

Organization: SUMNER PHYSICIAN PRACTICES LLC

PECOS Registration: Yes

Address:
3964 FRAZEYSBURG RD
ZANESVILLE, OH
ZIP 43701
Phone: (740) 455-4944
Get Directions

DR. Derald L. Madson, M.D. is a vascular surgery surgery in Zanesville, OH with 37 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. DR. Derald L. Madson, M.D. NPI is 1598769077. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduation Year:1987

The provider's business location address is:

3964 FRAZEYSBURG RD
ZANESVILLE, OH
ZIP 43701-924
Phone: (740) 455-4944
Fax: (740) 450-6199

The NPI 1598769077 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/13/2005 and was last updated on 4/2/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0129X	Surgery	Vascular Surgery	35059388	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	$$$$$$$$$00	OTHER	OHIO	WORKERS COMPENSATION
2	0890322	MEDICARE PIN	OHIO
3	F80262	MEDICARE UPIN	OHIO
4	000000122822	OTHER	OHIO	ANTHEM
5	311661239026	OTHER	OHIO	CARESOURCE
6	2131955	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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