Wade, Jeffrey Trent

Wade, Jeffrey Trent is an individual health care provider with primary practice located at 490 Dunlop Ln , Clarksville TN 37040-5007. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Wade, Jeffrey Trent can be contacted via phone (931) 245-8622.

Contact Information

Primary practice address
490 Dunlop Ln Clarksville TN 37040-5007
Phone: (931) 245-8622
Fax: (931) 245-8663
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 33993 Tennessee

Profile Details

NPI number 1679517833
LBN Legal business name Wade, Jeffrey Trent
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Nov 19th, 2021 - about 4 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 1679517833 NPPES
Tennessee MEDICAID Q004457

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