MEDICARE: DR. NORMAN R MCFADDEN JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	ME57721	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326021635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NORMAN R MCFADDEN JR. MD

Provider Business Mailing Address
First Line	:	14 W JORDAN ST STE 1J
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32501-1734
Country	:	US
Telephone Number	:	850-455-1252
Fax Number	:	844-683-8754

Provider Business Practice Location Address
First Line	:	14 W JORDAN ST STE 1J
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32501-1734
Country	:	US
Telephone Number	:	850-455-1252
Fax Number	:	844-683-8754

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	09/12/2019

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