MEDICARE: WADE BAGGS 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
1	207Q00000X	Family Medicine Physician	ME139820	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174050314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WADE BAGGS MD

Provider Business Mailing Address
First Line	:	313 NORTON DR STE 102
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5965
Country	:	US
Telephone Number	:	850-483-4440
Fax Number	:	850-483-4441

Provider Business Practice Location Address
First Line	:	313 NORTON DR STE 102
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5965
Country	:	US
Telephone Number	:	850-483-4440
Fax Number	:	850-483-4441

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2017
Last Update Date	:	01/26/2026

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