Provider Demographics
NPI:1700974516
Name:WADE, FRANK DARRELL (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:DARRELL
Last Name:WADE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:405 W SAM RIDLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-5626
Mailing Address - Country:US
Mailing Address - Phone:615-257-6027
Mailing Address - Fax:877-972-0257
Practice Address - Street 1:405 W SAM RIDLEY PKWY
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5626
Practice Address - Country:US
Practice Address - Phone:615-257-6027
Practice Address - Fax:877-972-0257
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN35806207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN35806OtherTN-MEDICAL LICENSE
TN3870149Medicaid
TN3870149Medicaid