Healthcare Provider Details

I. General information

NPI: 1326983271
Provider Name (Legal Business Name): MR. JAYSON J MCFADDEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 JANE RD APT 4
TROY AL
36079-3063
US

IV. Provider business mailing address

423 JANE RD APT 4
TROY AL
36079-3063
US

V. Phone/Fax

Practice location:
  • Phone: 903-353-4810
  • Fax:
Mailing address:
  • Phone: 903-353-4810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: