Wade, J Keith
Wade, J Keith is an individual health care provider with primary practice located at 405 Locust Ave , Fairmont WV 26554-4717. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wade, J Keith can be contacted via phone (304) 366-2020.Contact Information
Primary practice address
405 Locust Ave
Fairmont WV 26554-4717
Phone: (304) 366-2020
Fax: (304) 367-0863
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 729OD | West Virginia |
Profile Details
| NPI number | 1295850410 |
|---|---|
| LBN Legal business name | Wade, J Keith |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 20th, 2007 |
| Last updated | Apr 22nd, 2008 - about 17 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 | 1295850410 | NPPES |
| West Virginia | MEDICAID | 0150700000 |
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