Provider Demographics
NPI:1538048889
Name:MONROE, MADISON PEYTON (PT, DPT, NCS)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:PEYTON
Last Name:MONROE
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:
Other - Last Name:PEYTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:48 WANDERING OAKS LN
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-8701
Mailing Address - Country:US
Mailing Address - Phone:601-596-4511
Mailing Address - Fax:
Practice Address - Street 1:996 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2824
Practice Address - Country:US
Practice Address - Phone:850-863-7651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL40263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist