Provider Demographics
NPI:1467101691
Name:ENDICOTT, MADISON RYCE (DO)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:RYCE
Last Name:ENDICOTT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 JOHN LLOYD EVANS MEMORIAL DR STE 200
Practice Address - Street 2:
Practice Address - City:NELSONVILLE
Practice Address - State:OH
Practice Address - Zip Code:45764-2523
Practice Address - Country:US
Practice Address - Phone:740-753-7323
Practice Address - Fax:740-753-7388
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58.032825207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine