Provider Demographics
NPI:1093764284
Name:LADDEN, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:LADDEN
Suffix:
Gender:M
Credentials:MD
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 150520
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75915-0520
Mailing Address - Country:US
Mailing Address - Phone:936-631-6777
Mailing Address - Fax:936-631-6778
Practice Address - Street 1:800 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-1658
Practice Address - Country:US
Practice Address - Phone:270-326-3800
Practice Address - Fax:270-326-3805
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS15882207RC0000X
TXG8228207RC0000X, 208G00000X
KY56743208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09406262Medicaid
KY7100822120Medicaid
MS09406262Medicaid
MS780000058Medicare PIN