Healthcare Provider Details

I. General information

NPI: 1548239015
Provider Name (Legal Business Name): H. KENNETH MCFADDEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 06/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HOSPITAL WAY NORTH VALLEY HOSPITAL
WHITEFISH MT
59937-0000
US

IV. Provider business mailing address

1600 HOSPITAL WAY NORTH VALLEY HOSPITAL
WHITEFISH MT
59937-7849
US

V. Phone/Fax

Practice location:
  • Phone: 406-863-3500
  • Fax: 406-862-7805
Mailing address:
  • Phone: 406-863-3500
  • Fax: 406-862-7805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4450
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT4450
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: