Organization
MARK D. WADE O D P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK D. WADE OD (PRESIDENT)
(618) 462-9818
Entity
Organization
Contact information
Practice address
111 E 4TH ST STE 440, ALTON, IL 62002-6206
(618) 462-9818
(314) 741-4947
Mailing address
111 E 4TH ST STE 440, ALTON, IL 62002-6206
(618) 462-9818
(314) 741-4947
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MO2999
MO
Other
Enumeration date
05/26/2016
Last updated
07/25/2023
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