Individual
FREDERICK T MCFALL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 E MAIN ST, ATTN: RADIOLOGY DEPARTMENT, DANVILLE, IN 46122-1948
(317) 745-3425
Mailing address
PO BOX 727, CLOVERDALE, IN 46120-0727
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01032820A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000223219
ANTHEM
IN
05
—
100320660
—
IN
01
—
139215XX
PREFERRED CARE
IN
01
—
300130121
RAILROAD MEDICARE
—
Enumeration date
03/28/2007
Last updated
09/20/2013
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