Provider Demographics
NPI:1093451767
Name:MCFADDEN, TEAGAN JOSEPH (BS, PRS)
Entity Type:Individual
Prefix:
First Name:TEAGAN
Middle Name:JOSEPH
Last Name:MCFADDEN
Suffix:
Gender:M
Credentials:BS, PRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 ARCH ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1518
Mailing Address - Country:US
Mailing Address - Phone:740-804-6800
Mailing Address - Fax:740-721-4155
Practice Address - Street 1:382 ARCH ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1518
Practice Address - Country:US
Practice Address - Phone:740-804-6800
Practice Address - Fax:740-721-4155
Is Sole Proprietor?:No
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.003163175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist