Provider Demographics
NPI:1235154998
Name:MCFADDEN, BETTY JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BETTY
Middle Name:JEAN
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BAILESS CT
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-4654
Mailing Address - Country:US
Mailing Address - Phone:864-380-9651
Mailing Address - Fax:864-242-2516
Practice Address - Street 1:4200 E NORTH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-2437
Practice Address - Country:US
Practice Address - Phone:864-292-2266
Practice Address - Fax:864-292-2516
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11547207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC201895666001OtherBC/BS OF SOUTH CAROLINA
SC201895666001OtherBC/BS OF SOUTH CAROLINA
SCBM3570377OtherDEA NUMBER