Healthcare Provider Details

I. General information

NPI: 1245398981
Provider Name (Legal Business Name): LEE ALAN MCFADDEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 02/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BELOIT CLINIC 1905 E HUEBBE PARKWAY
BELOIT WI
53511-1842
US

IV. Provider business mailing address

BELOIT HEALTH SYSTEMS INC 1905 E HUEBBE PARKWAY
BELOIT WI
53511-1842
US

V. Phone/Fax

Practice location:
  • Phone: 608-364-2230
  • Fax: 608-363-7394
Mailing address:
  • Phone: 608-364-2200
  • Fax: 608-363-7395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number036-138188
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberDR.0043356
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036-138188
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number036.138188
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number70525-20
License Number StateWI
# 6
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number70525-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: