person
Mr. Kenneth Alan Wade, PA
Medical Physician Assistant in Logan, Utah
NPI 1699826149

Kenneth Alan Wade is a Medical Physician Assistant based in Logan, UT and is specialized in Medical. Kenneth Alan Wade practices in Logan, UT and has the professional credentials of PA. The NPI Number for Kenneth Alan Wade is 1699826149 and holds a License No. 1015921206 (Utah).

The current practice location address for Kenneth Alan Wade is 1325 N 600 E, Logan, UT and can be reached out via phone at 435-753-9999 and via fax at 435-753-2301.

Location: 1325 N 600 E, Logan, UT, 84341-6738
person
Provider Profile Details
NPI Number
1699826149
Provider Name
Kenneth Alan Wade
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
1325 N 600 E, Logan, UT, 84341-6738
Phone Number
435-753-9999
Fax Number
435-753-2301
Provider Enumeration Date
01/12/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1015921206 01 UT STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
1325 N 600 E
City
State
Zip
84341-6738
Phone Number
435-753-9999
Fax Number
435-753-2301
person
Provider Business Mailing Address Details
Address
1325 N 600 E
City
State
Zip
84341-6738
Phone Number
435-753-9999
Fax Number
435-753-2301
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
1015921206 (Utah)
Definition
Definition to come...
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