| Wade Family Medicine, Llc. | |
|
899 Highway 51 S Covington TN 38019-2568 | |
| (901) 244-4646 | |
| (901) 244-4647 |
| Full Name | Wade Family Medicine, Llc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 899 Highway 51 S, Covington, Tennessee |
| Authorized Official Name and Position | Modeanna Leigh Wade (FNP) |
| Authorized Official Contact | 9012444648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wade Family Medicine, Llc. Po Box 369 Millington TN 38083-0369 Ph: (901) 244-4648 | Wade Family Medicine, Llc. 899 Highway 51 S Covington TN 38019-2568 Ph: (901) 244-4646 |
| NPI Number | 1629586375 |
|---|---|
| Provider Enumeration Date | 01/16/2018 |
| Last Update Date | 07/09/2024 |
| Medicare PECOS PAC ID | 7911258322 |
|---|---|
| Medicare Enrollment ID | O20180925001187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629586375 | NPI | - | NPPES |
| 1525986 | Medicaid | TN |
| Provider Name | Modeanna L Wade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760767016 PECOS PAC ID: 6901079037 Enrollment ID: I20111104000197 |
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