| Dr Tarence E Wade, MD | |
|
960 Avent Dr, Grenada, MS 38901-5230 | |
| (662) 227-7172 | |
| Not Available |
| Full Name | Dr Tarence E Wade |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 34 Years |
| Location | 960 Avent Dr, Grenada, Mississippi |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043246259 | NPI | - | NPPES |
| 00115897 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 11435 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Northwest Mississippi Medical Center | Clarksdale, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Panola Physician Group Llc | 2668715624 | 14 |
| Correct Care, Inc. | 8628980992 | 71 |
| Entity Name | Correct Care, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215987441 PECOS PAC ID: 8628980992 Enrollment ID: O20131122000662 |
| Entity Name | Panola Physician Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528528874 PECOS PAC ID: 2668715624 Enrollment ID: O20190515002618 |
| Entity Name | Coffee County Physician Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437164878 PECOS PAC ID: 4082671235 Enrollment ID: O20190612002779 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tarence E Wade, MD 14050 Nw 14th St, Suite 190, Sunrise, FL 33323-2865 Ph: (800) 424-3672 | Dr Tarence E Wade, MD 960 Avent Dr, Grenada, MS 38901-5230 Ph: (662) 227-7172 |
Dr. Dennis W Aust, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 960 Avent Dr, Grenada, MS 38901 Phone: 800-424-3672 Fax: 954-377-3042 | |
Hubert D Taylor Ii, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 960 Avent Dr, Grenada, MS 38901 Phone: 662-227-7000 | |
Dr. Stephen D Butler, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 960 Avent Dr, Grenada, MS 38901 Phone: 662-227-7172 |