Provider Demographics
NPI:1174246722
Name:ANDROW, MADISON ELIZABETH (OD)
Entity type:Individual
Prefix:DR
First Name:MADISON
Middle Name:ELIZABETH
Last Name:ANDROW
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 BUCKBOARD LN
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-2116
Mailing Address - Country:US
Mailing Address - Phone:614-257-7291
Mailing Address - Fax:
Practice Address - Street 1:6191 S STATE ST SPC 1661
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7258
Practice Address - Country:US
Practice Address - Phone:614-257-7291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT128767969934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist