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Organization
STANLEY A. WADE, JR., MD, PLLC
Active
Organization
STANLEY A. WADE, JR., MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY A. WADE JR. M.D. (OWNER)
(205) 459-4778
Entity
Organization
Contact information
Practice address
1800 12TH ST, SUITE 3A, MERIDIAN, MS 39301-4158
(601) 703-9223
(601) 703-9405
Mailing address
PO BOX 328, MERIDIAN, MS 39302-0328
(601) 703-9506
(601) 703-3264
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06874076
—
MS
01
—
DA7320
RAILROAD MEDICARE
—
Enumeration date
05/01/2006
Last updated
08/22/2020
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