Organization
J. WADE M. D. - NEUROLOGY, P.C.
Active
Other names
J. WADE M. D. - NEUROLOGY, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME B WADE M. D. (OWNER)
(918) 587-5100
Entity
Organization
Contact information
Practice address
2526 W EDISON ST, TULSA, OK 74127-6128
(918) 587-5100
Mailing address
PO BOX 2169, TULSA, OK 74101-2169
(918) 587-5100
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
14598
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100250220B
—
OK
Enumeration date
02/23/2007
Last updated
06/20/2008
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