Provider Demographics
NPI:1588654768
Name:WADLINGTON, JOHN SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SCOTT
Last Name:WADLINGTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:144 GOULD ST STE 150
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM HEIGHTS
Mailing Address - State:MA
Mailing Address - Zip Code:02494-2309
Mailing Address - Country:US
Mailing Address - Phone:339-204-9516
Mailing Address - Fax:617-754-8791
Practice Address - Street 1:1493 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1099
Practice Address - Country:US
Practice Address - Phone:617-665-1634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2023-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA75235207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3090469Medicaid
MA075235OtherTUFTS HEALTH PLAN
MAJ12295OtherBCBS MA
MA3090469Medicaid
F24258Medicare UPIN