Basic Information
Provider Information
NPI: 1548239015
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCFADDEN
FirstName: H. KENNETH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1600 HOSPITAL WAY
Address2: NORTH VALLEY HOSPITAL
City: WHITEFISH
State: MT
PostalCode: 599377849
CountryCode: US
TelephoneNumber: 4068633500
FaxNumber: 4068627805
Practice Location
Address1: 1600 HOSPITAL WAY
Address2: NORTH VALLEY HOSPITAL
City: WHITEFISH
State: MT
PostalCode: 599370000
CountryCode: US
TelephoneNumber: 4068633500
FaxNumber: 4068627805
Other Information
ProviderEnumerationDate: 03/16/2006
LastUpdateDate: 06/28/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMT4450MTN Allopathic & Osteopathic PhysiciansInternal Medicine 
207P00000X4450MTY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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