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Organization

WADE FAULKNER, MD, PC

Active
Other names
VisionAmerica
Organization subpart
No

Provider details

NPI number
Authorized official
HENRY WADE FAULKNER M.D. (OWNER/PRESIDENT)
(251) 471-3309
Entity
Organization

Contact information

Practice address
3290 DAUPHIN ST, SUITE 401, MOBILE, AL 36606-4062
(251) 471-3309
(251) 471-5046
Mailing address
250 STATE FARM PKWY, BIRMINGHAM, AL 35209-7181
(205) 943-4650
(205) 943-4688

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1740210822
AL
05
529919050
AL
01
DB0731
RR MEDICARE PGBA
Enumeration date
07/04/2006
Last updated
06/12/2008
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