Provider Demographics
NPI:1326015504
Name:MADISON, CHRISTOPHER K JR (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:K
Last Name:MADISON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:740-845-7700
Mailing Address - Fax:740-845-7701
Practice Address - Street 1:210 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-1115
Practice Address - Country:US
Practice Address - Phone:740-845-7700
Practice Address - Fax:740-845-7701
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35086377208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000374961OtherANTHEM
OH000000502706OtherANTHEM
OH2599871Medicaid
OHP00279362OtherRAILROAD MEDICARE PIN
OHI40886Medicare UPIN
OHMA4168853Medicare ID - Type UnspecifiedBEAVERCREEK
OH4168852Medicare PIN
OH000000502706OtherANTHEM
OHH278450Medicare PIN