Provider Demographics
NPI:1114721974
Name:MADISON, GEORGE H JR
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:H
Last Name:MADISON
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-1039
Mailing Address - Country:US
Mailing Address - Phone:812-962-0240
Mailing Address - Fax:812-962-0505
Practice Address - Street 1:1033 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-1039
Practice Address - Country:US
Practice Address - Phone:812-962-0240
Practice Address - Fax:812-962-0505
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No171WV0202XOther Service ProvidersContractorVehicle Modifications
No171WH0202XOther Service ProvidersContractorHome Modifications