Provider Demographics
NPI:1699799692
Name:WADE, JOHN FLETCHER III (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FLETCHER
Last Name:WADE
Suffix:III
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 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-4123
Mailing Address - Fax:970-624-2416
Practice Address - Street 1:100 COOK ST STE 400
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5340
Practice Address - Country:US
Practice Address - Phone:720-516-9421
Practice Address - Fax:970-516-9449
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64030207RC0200X, 207RP1001X
CODR.0028472207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18927ZOtherBCBS FLORIDA
FL372958300Medicaid
290012121OtherRAILROAD MEDICARE
AL59146831OtherBCBS ALABAMA
162592600OtherFEDERAL BLACK LUNG
FLZ042OtherMED3000
FLZ042OtherWELLCARE
FLZ042OtherWELLCARE
FL18927ZOtherBCBS FLORIDA