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Individual

THOMAS A. WADE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
610 19TH ST, COLUMBUS, GA 31901-1528
(706) 322-7884
(706) 660-2145
Mailing address
PO BOX 9247, COLUMBUS, GA 31908-9247
(706) 322-7884
(706) 660-2145

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16194
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000144152J
GA
05
00144152F
GA
01
110054050
RAIL ROAD MEDICARE
GA
Enumeration date
07/27/2006
Last updated
05/06/2015
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