Provider Demographics
NPI:1538100417
Name:NADEN, DEAN ROBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:ROBERT
Last Name:NADEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 HIGHWAY 78 E
Mailing Address - Street 2:P.O. BOX 708
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-3430
Mailing Address - Country:US
Mailing Address - Phone:205-387-2253
Mailing Address - Fax:205-387-2405
Practice Address - Street 1:2708 HIGHWAY 78 EAST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501
Practice Address - Country:US
Practice Address - Phone:205-387-2253
Practice Address - Fax:205-387-2253
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO-690207P00000X
ALDO690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH33304Medicare UPIN