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General NPI Number Information
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NPI Number | 1437156189
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Entity Type | Individual
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Provider Name | MICHAEL K. MCFADDEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 202 PERRY HWY STE 101
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City | HAWKINSVILLE
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State | GA
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Zip | 31036-6748
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Country | US
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Telephone | 478-892-7246
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Fax | 478-892-7247
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Provider Business Mailing Address
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Address Line | 3356 VINEVILLE AVE
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City | MACON
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State | GA
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Zip | 31204-2328
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Country | US
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Telephone | 478-476-9886
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Fax | 478-476-9976
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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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ME166528
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 89324
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License Number State | GA
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