Individual
PAUL DAVID WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Mailing address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12173
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12173
PHARMACY LICENSE
KS
Enumeration date
10/01/2009
Last updated
10/01/2009
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