| Wade G Douglas, MD | |
|
1401 Centerville Road, Suite 100, Tallahassee, FL 32308-3656 | |
| (850) 877-5183 | |
| (850) 656-1288 |
| Full Name | Wade G Douglas |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 1401 Centerville Road, Tallahassee, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689634388 | NPI | - | NPPES |
| 64102411 | Medicaid | KY | |
| 2586732 | Medicaid | OH | |
| 3810002707 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 21963 (West Virginia) | Secondary |
| 208600000X | Surgery | ME120744 (Florida) | Primary |
| 2086X0206X | Surgery - Surgical Oncology | 21963 (West Virginia) | Secondary |
| Entity Name | Tallahassee Memorial Healthcare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104115948 PECOS PAC ID: 6103724778 Enrollment ID: O20031222000279 |
| Entity Name | Doctors Memorial Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285709451 PECOS PAC ID: 5092614503 Enrollment ID: O20040114000009 |
| Entity Name | Madison County Hospital Health Systems Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104821461 PECOS PAC ID: 2860474111 Enrollment ID: O20040602000398 |
| Mailing Address | Practice Location Address |
|---|---|
| Wade G Douglas, MD 1401 Centerville Road, Suite 100, Tallahassee, FL 32308-3656 Ph: (850) 877-5183 | Wade G Douglas, MD 1401 Centerville Road, Suite 100, Tallahassee, FL 32308-3656 Ph: (850) 877-5183 |
Dr. Herbert B Rubin, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1460 Marion Ave, Tallahassee, FL 32303 Phone: 850-222-1108 Fax: 850-224-5522 | |
Dr. John L Williams, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 4781 Williams Rd, Tallahassee, FL 32311 Phone: 850-878-1375 Fax: 850-877-5119 | |
Dr. Shawn Michael Weeks, D.O. Surgery Medicare: Medicare Enrolled Practice Location: 2626 Capital Medical Blvd, Tallahassee, FL 32308 Phone: 850-325-5000 | |
Leo Christopher Derosier, MD Surgery Medicare: May Accept Medicare Assignments Practice Location: 2030 Fleischmann Rd, Tallahassee, FL 32308 Phone: 850-219-2000 Fax: 850-877-2138 | |
Dr. John Neal, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 2910 Capital Medical Blvd, Tallahassee, FL 32308 Phone: 850-656-2926 Fax: 850-877-7151 | |
Dr. Lawrence D Kaelin, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2631 Centennial Blvd, Suite 100, Tallahassee, FL 32308 Phone: 850-877-8539 Fax: 850-877-6674 | |
Dr. Thomas I Lawhorn Jr., M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1911 Miccosukee Rd, Tallahassee, FL 32308 Phone: 850-877-8539 Fax: 850-877-6674 |