Provider Demographics
NPI:1497778369
Name:JAMES S. MCFADDEN, MD,PA
Entity Type:Organization
Organization Name:JAMES S. MCFADDEN, MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:MCFADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-295-2920
Mailing Address - Street 1:35 MCDONALD RD W
Mailing Address - Street 2:PO BOX 5398
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8946
Mailing Address - Country:US
Mailing Address - Phone:910-295-2920
Mailing Address - Fax:910-295-4640
Practice Address - Street 1:35 MCDONALD RD W
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8946
Practice Address - Country:US
Practice Address - Phone:910-295-2920
Practice Address - Fax:910-295-4640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC40471207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC201498OtherMEDICARE PTAN
NC02452OtherBCBS GROUP NUMBER
NC56525OtherBCBS
NC7902452Medicaid
NCNPB002OtherSC EDS
NC201498BOtherMEDICARE INDIVIDUAL ID #
NCQC0313OtherSC EDS INDIVIDUAL
NC050007881OtherRR MEDICARE