Provider Demographics
NPI:1326021635
Name:MCFADDEN, NORMAN R JR (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:R
Last Name:MCFADDEN
Suffix:JR
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 1:14 W JORDAN ST STE 1J
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-1734
Mailing Address - Country:US
Mailing Address - Phone:850-455-1252
Mailing Address - Fax:844-683-8754
Practice Address - Street 1:14 W JORDAN ST STE 1J
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1734
Practice Address - Country:US
Practice Address - Phone:850-455-1252
Practice Address - Fax:844-683-8754
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57721208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0634786000Medicaid