Provider Demographics
NPI:1295022648
Name:DR. SHARLA GEORGE MCFADDEN DC
Entity Type:Organization
Organization Name:DR. SHARLA GEORGE MCFADDEN DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARLA
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCFADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:660-973-0616
Mailing Address - Street 1:1201 LANDMARK AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-3701
Mailing Address - Country:US
Mailing Address - Phone:816-792-1766
Mailing Address - Fax:816-792-1201
Practice Address - Street 1:1201 LANDMARK AVE
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-3701
Practice Address - Country:US
Practice Address - Phone:816-792-1766
Practice Address - Fax:816-792-1201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-06
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007003491111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA3468Medicare PIN