Individual
PHILIP MARK WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2407 HELTON DR, FLORENCE, AL 35630-1067
(256) 718-5900
(256) 718-5918
Mailing address
2407 HELTON DR, FLORENCE, AL 35630-1067
(256) 718-5900
(256) 718-5918
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
12686
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000015991
—
AL
01
—
51015991
BLUE CROSS BLUE SHIELD
AL
Enumeration date
10/03/2006
Last updated
06/10/2010
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