Individual
JOHN R. WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1049 STATE ROAD 229, BATESVILLE, IN 47006-6808
(812) 934-2117
(812) 933-0913
Mailing address
PO BOX 149, BATESVILLE, IN 47006-0149
(812) 934-2117
(812) 933-0913
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
IN 1811
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000031291
ANTHEM
IL
05
—
100051770
—
IN
01
—
410048459
RAILROAD MEDICARE
IN
Enumeration date
08/19/2005
Last updated
05/06/2008
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