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Individual

BILLY KOSSUTH WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 WERNER ST., HOT SPRINGS, AR 71913
(501) 622-1043
(501) 622-2033
Mailing address
PO BOX 29001, STE 900, HOT SPRINGS, AR 71903-9001
(501) 622-1043
(501) 622-2033

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J5942
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100079170A
OK
05
103425001
AK
05
115829701
TX
05
190656201
TX
01
554306972
MEDICARE LINKED
Enumeration date
06/17/2006
Last updated
05/13/2013
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