Douglas, Wade G

Douglas, Wade G is an individual health care provider with primary practice located at 1401 Centerville Road Suite 100, Tallahassee FL 32308-3656. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Oncology. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Douglas, Wade G can be contacted via phone (850) 877-5183.

Contact Information

Primary practice address
1401 Centerville Road Suite 100 Tallahassee FL 32308-3656
Phone: (850) 877-5183
Fax: (850) 656-1288
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 21963 West Virginia
Allopathic & Osteopathic Physicians / Surgery 208600000X ME120744 Florida
Allopathic & Osteopathic Physicians / Surgical Oncology 2086X0206X 21963 West Virginia

Profile Details

NPI number 1689634388
LBN Legal business name Douglas, Wade G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2006
Last updated Aug 19th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689634388 NPPES
Kentucky MEDICAID 64102411
Kentucky MEDICAID 2586732
Kentucky MEDICAID 3810002707

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