Provider Demographics
NPI:1942308747
Name:MCFADDEN FAMILY PRACTICE PC
Entity Type:Organization
Organization Name:MCFADDEN FAMILY PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-845-7765
Mailing Address - Street 1:62 GREENBRIAR DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LEECHBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15656-8209
Mailing Address - Country:US
Mailing Address - Phone:724-845-7765
Mailing Address - Fax:724-845-8418
Practice Address - Street 1:62 GREENBRIAR DR
Practice Address - Street 2:SUITE 1
Practice Address - City:LEECHBURG
Practice Address - State:PA
Practice Address - Zip Code:15656-8209
Practice Address - Country:US
Practice Address - Phone:724-845-7765
Practice Address - Fax:724-845-8418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012183600003Medicaid
PA0012183600003Medicaid