Provider Demographics
NPI:1821319971
Name:MCFADEN, THOMAS GAVIN (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:GAVIN
Last Name:MCFADEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 W LAKESHORE DR
Mailing Address - Street 2:STE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7271
Mailing Address - Country:US
Mailing Address - Phone:205-930-2950
Mailing Address - Fax:205-930-2957
Practice Address - Street 1:1 W LAKESHORE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-0500
Practice Address - Country:US
Practice Address - Phone:205-930-2950
Practice Address - Fax:205-930-2957
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALMD.31606207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I086297Medicare PIN