Provider Demographics
NPI:1659250728
Name:KILLPACK, MADISON HOGGE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:HOGGE
Last Name:KILLPACK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2526 N 800 E
Mailing Address - Street 2:
Mailing Address - City:NORTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84414-2961
Mailing Address - Country:US
Mailing Address - Phone:801-866-3682
Mailing Address - Fax:
Practice Address - Street 1:WEBER STATE UNIVERSITY 3875 STADIUM WAY DEPT 3913
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84408-0001
Practice Address - Country:US
Practice Address - Phone:801-626-7210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14240615-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant