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General NPI Number Information
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NPI Number | 1235154998
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Entity Type | Individual
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Provider Name | BETTY JEAN MCFADDEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 4200 E NORTH ST SUITE 5
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City | GREENVILLE
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State | SC
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Zip | 29615-2437
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Country | US
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Telephone | 864-292-2266
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Fax | 864-292-2516
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Provider Business Mailing Address
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Address Line | 30 BAILESS CT
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City | GREER
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State | SC
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Zip | 29650-4654
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Country | US
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Telephone | 864-380-9651
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Fax | 864-242-2516
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11547
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License Number State | SC
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