Organization
WBD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK C WADE JR. M.D. (PRESIDENT)
(601) 849-7240
Entity
Organization
Contact information
Practice address
376A SIMPSON HIGHWAY 149, MAGEE, MS 39111-3409
(601) 849-7240
(601) 849-7244
Mailing address
360 SIMPSON HIGHWAY 149 STE 370, MAGEE, MS 39111-3843
(601) 849-7240
(601) 849-7244
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10798
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09883351
—
MS
Enumeration date
09/22/2006
Last updated
03/26/2018
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