Wade, Kenneth Alan

Wade, Kenneth Alan is an individual health care provider with primary practice located at 1325 N 600 E Suite 102, Logan UT 84341-6738. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Wade, Kenneth Alan can be contacted via phone (435) 753-9999.

Contact Information

Primary practice address
1325 N 600 E Suite 102 Logan UT 84341-6738
Phone: (435) 753-9999
Fax: (435) 753-2301
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1015921206 Utah

Profile Details

NPI number 1699826149
LBN Legal business name Wade, Kenneth Alan
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2007
Last updated Nov 29th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699826149 NPPES
Utah Other 1015921206 STATE LICENSE

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