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NPI Code Detail

MEDICARE: DR. WADE GRINDLE M.D.

MEDICARE: DR. WADE GRINDLE M.D.
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
1207L00000XAnesthesiology Physician44209AZ

General Provider Information

NPI Number : 1922262286
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WADE GRINDLE M.D.
Provider Business Mailing Address
First Line : PO BOX 11663
Second Line :
City : FORT MOHAVE
State : AZ
Zip : 86427-1663
Country : US
Telephone Number : 818-403-5329
Fax Number :
Provider Business Practice Location Address
First Line : 5330 S HIGHWAY 95
Second Line :
City : FORT MOHAVE
State : AZ
Zip : 86426-9225
Country : US
Telephone Number : 928-788-7090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2008
Last Update Date : 01/11/2026

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Directions to “ DR. WADE GRINDLE M.D.” Practice Location

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