Individual
DR. JAMES G WAKEFIELD III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
919 E GRACE ST, RENSSELAER, IN 47978-3207
(219) 866-0485
(219) 866-0837
Mailing address
919 E GRACE ST, RENSSELAER, IN 47978-3207
(219) 866-0485
(219) 866-0837
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01060733A
IN
207Q00000X
Family Medicine Physician
Primary
01060733A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200523870
—
IN
05
—
200523870A
—
IN
01
—
P00303729
PALMETTO GBA
IN
Enumeration date
09/20/2005
Last updated
02/13/2026
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