Organization
WADE PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN F WADE (OWNER)
(918) 683-8442
Entity
Organization
Contact information
Practice address
3505 W BROADWAY, MUSKOGEE, OK 74401
(918) 683-8442
(918) 683-8390
Mailing address
3505 W BROADWAY, MUSKOGEE, OK 74401
(918) 683-8442
(918) 683-8390
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
18036
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01837071
—
MS
Enumeration date
02/13/2006
Last updated
08/22/2020
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