Provider Demographics
NPI:1588757967
Name:WILLIAMS, WADE L (MD)
Entity type:Individual
Prefix:DR
First Name:WADE
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 KESSLER ST STE 204
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2553
Mailing Address - Country:US
Mailing Address - Phone:913-632-9770
Mailing Address - Fax:913-632-9799
Practice Address - Street 1:7450 KESSLER ST STE 204
Practice Address - Street 2:
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-2553
Practice Address - Country:US
Practice Address - Phone:913-632-9770
Practice Address - Fax:913-632-9799
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0423900207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS058661OtherBCBS KANSAS
MO203876206Medicaid
KS100285820BMedicaid
24521076OtherBCBS KANSAS CITY
KS058661Medicare ID - Type UnspecifiedKANSAS
290012144Medicare ID - Type UnspecifiedRAILROAD
KS058661OtherBCBS KANSAS
A559827Medicare ID - Type UnspecifiedKANSAS CITY