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:
Health care specialties
| Specialty | Code | License # | 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 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689634388 | NPPES |
| Kentucky | MEDICAID | 64102411 | |
| Kentucky | MEDICAID | 2586732 | |
| Kentucky | MEDICAID | 3810002707 |
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