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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