Provider Demographics
NPI:1881627735
Name:MCADOO, STEPHEN DOUGLAS (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DOUGLAS
Last Name:MCADOO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 TUTOR LN
Mailing Address - Street 2:STE 102
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7295
Mailing Address - Country:US
Mailing Address - Phone:270-247-5785
Mailing Address - Fax:270-247-0608
Practice Address - Street 1:510 S 6TH ST
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:KY
Practice Address - Zip Code:42066-2314
Practice Address - Country:US
Practice Address - Phone:270-247-5785
Practice Address - Fax:270-247-0608
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003093A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYU85940Medicare UPIN
KY0731301Medicare ID - Type Unspecified