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Individual

MR. TAYLOR MAX WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-C

Contact information

Practice address
1505 PELHAM RD S STE 2, JACKSONVILLE, AL 36265-3707
(256) 435-7300
(256) 435-7305
Mailing address
1505 PELHAM RD S STE 2, JACKSONVILLE, AL 36265-3707
(256) 435-7300
(256) 435-7305

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F01191470
AL
363LF0000X
Family Nurse Practitioner
1-138196
AL

Other

Enumeration date
02/08/2019
Last updated
01/14/2021
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