Dr. Jeffery Trad Wadsworth
Otolaryngologist (ENT Doctor) Pediatric Otolaryngology Plastic Surgeon (Head & Neck)
1365a Clifton Rd Ne Room A2303
Atlanta
, Georgia 30322-1013
Dr. Jeffery Trad Wadsworth
Otolaryngologist (ENT Doctor) Pediatric Otolaryngology Plastic Surgeon (Head & Neck)
1365a Clifton Rd Ne Room A2303
Atlanta
, Georgia 30322-1013
(404) 778-4295
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
- Pediatric Otolaryngology
- Plastic Surgeon (Head & Neck)
Languages spoken
- English
Location
First Address
- Dr. Jeffery Trad Wadsworth
- 1365a Clifton Rd Ne Room A2303
- Atlanta, GA
- Zip : 30322-1013
- Fax : (404) 778-4295
- Phone : (404) 778-3381
Second Address
- Dr. Jeffery Trad Wadsworth
- 1365a Clifton Rd Ne Room A2303
- Atlanta, GA
- Zip : 30322-1013
- Fax : (404) 778-4295
- Phone : (404) 778-3381
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Y00000X | Otolaryngologist (ENT Doctor) | 0101231639 | VA |
| N | 207YP0228X | Pediatric Otolaryngology | 0101231639 | VA |
| Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 0101231639 | VA |
National Provider Identifier
| NPI | 1578531216 |
|---|---|
| Provider Name | Dr. Jeffery Trad Wadsworth |
| First Address | Atlanta, GA 30322-1013 |
| Second Address | Atlanta, GA 30322-1013 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/03/2006 |
| Last Update Date | 01/07/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| -004 | TRICARE/CHAMPUS (01) | VA |
| 006503004 | (05) | VA |
| 064P3 | BC/BS (01) | NC |
| 294562 | UHC/MAMSI (01) | VA |
| 41264 | SENTARA (01) | VA |
| 434684 | ANTHEM (01) | VA |
| 89064P3 | (05) | NC |
| H05758 | (02) | VA |
| PAR | AETNA (01) | VA |
| PAR | CIGNA (01) | VA |
| PAR | CORVEL/CORCARE (01) | VA |
| PAR | FIRST HEALTH COMMERCIAL (01) | VA |
| PAR | MULTIPLAN (01) | VA |
| PAR | USA MANAGED CARE (01) | VA |
| PAR | VA HEALTH NETWORK (01) | VA |
| PAR | VA PREMIER HEALTH (01) | VA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.