Kenneth Alan Wade is a Medical in Logan, Utah. Kenneth Alan Wade practices all healthcare services and medical treatments related to Medical. The NPI Number for Kenneth Alan Wade is 1699826149. The last update date is 2016-11-29.
Kenneth Alan Wade's current location address is 1325 N 600 E, Logan, Utah. You can contact this provider via phone number 4357539999 and fax number 4357532301. The mailing address for Kenneth Alan Wade is 1325 N 600 E, Logan, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Alan Wade |
|---|---|
| Address | 1325 N 600 E, Logan, Utah |
| Phone Number | 4357539999 |
| Fax Number | 4357532301 |
| Sole Proprietor | N |
| Credentials | P.A |
NPI Number Detail
| NPI Number | 1699826149 |
|---|---|
| Provider Enumeration Date | 2007-01-12 |
| Last Updated Date | 2016-11-29 |
Provider Mailing Address Detail
| Address | 1325 N 600 E |
|---|---|
| City | Logan |
| State | Utah (UT) |
| Post Code | 843416738 |
| Phone Number | 4357539999 |
| Fax Number | 4357532301 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | 1015921206 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1015921206 | UT | STATE LICENSE |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Kenneth Alan Wade by the Centers for Medicare & Medicaid Services?
The Kenneth Alan Wade has been issued the NPI (National Provider Identifier) 1699826149, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Kenneth Alan Wade?
The Kenneth Alan Wade is situated at 1325 N 600 E, in the city of Logan, state of UT, with the zip code 843416738.
What is the Kenneth Alan Wade's area of specialization and corresponding taxonomy classification?
The Kenneth Alan Wade's specialty field is Medical, and it falls under the taxonomy code 363Am0700X, which categorizes healthcare providers based on their specialties.
On what date did the Kenneth Alan Wade receive its 1699826149 assignment from the Centers for Medicare & Medicaid Services?
The Kenneth Alan Wade was assigned its 1699826149 by the Centers for Medicare & Medicaid Services on 2007-01-12.
When was the information related to Kenneth Alan Wade most recently updated or refreshed?
The details pertaining to the Kenneth Alan Wade, including its address, specialty, and other relevant information, were last updated or refreshed on 2016-11-29.