| Doctor Name: | WADE BABCOCK |
| NPI Number: | 1033173786 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PAC |
| License Number: | 1500615 |
| Business Practice Address: | 1514 K 96 Highway Great Bend, KS - 67530 |
| Business Phone Number: | 6207924383 |
| Business Fax Number: | 6207922058 |
| Mailing Address: | 1514 K 96 Highway, GREAT BEND |
| State: | KS |
| Postal Code: | 67530 |
| Phone Number: | 6207924383 |
| Fax Number: | 6207922058 |
| NPI Enumeration Date: | 04/12/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 1500615 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |