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NPI Code Detail

MEDICARE: DR. WADE CARL WERNECKE MD

MEDICARE: DR. WADE CARL WERNECKE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PE0004XEmergency Medical Services (Emergency Medicine) Physician31819MN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
45H0526972OTHERARMEDICARELINKED

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12M151WEOTHERMNBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3HP31594OTHERMNHEALTHPARTNERS

General Provider Information

NPI Number : 1184613929
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WADE CARL WERNECKE MD
Provider Business Mailing Address
First Line : 300 WERNER ST
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-6406
Country : US
Telephone Number : 501-622-1043
Fax Number : 501-622-1199
Provider Business Practice Location Address
First Line : 300 WERNER ST
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-6406
Country : US
Telephone Number : 501-622-1043
Fax Number : 501-622-1199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2005
Last Update Date : 02/07/2008

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Directions to “ DR. WADE CARL WERNECKE MD” Practice Location

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