Provider Demographics
NPI:1770808388
Name:MADSEN, DOROTHY M (DO)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:M
Last Name:MADSEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:M
Other - Last Name:HARGIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:77 HOSPITAL AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2550
Mailing Address - Country:US
Mailing Address - Phone:413-663-8365
Mailing Address - Fax:
Practice Address - Street 1:77 HOSPITAL AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2550
Practice Address - Country:US
Practice Address - Phone:413-663-8365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA254078208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics