Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 036-138188 | IL |
Y | 207X00000X | Orthopaedic Surgeon | 70525-20 | WI |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 036-138188 | IL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 036.138188 | IL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 70525-20 | WI |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | DR.0043356 | CO |
NPI | 1245398981 |
---|---|
Provider Name | Dr. Lee Alan Mcfadden |
First Address | Beloit, WI 53511-1842 |
Second Address | Beloit, WI 53511-1842 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 15/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03613188 | (05) | IL |