Provider Demographics
NPI:1487666129
Name:MCFADDIN, DAVID MOORE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MOORE
Last Name:MCFADDIN
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 1:2760 SE 17TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5571
Mailing Address - Country:US
Mailing Address - Phone:352-867-8551
Mailing Address - Fax:352-867-7669
Practice Address - Street 1:2760 SE 17TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5571
Practice Address - Country:US
Practice Address - Phone:352-867-8551
Practice Address - Fax:352-867-7669
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51843174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL048230700Medicaid
FL048230700Medicaid
FL05802Medicare UPIN