DR. GORDON FREDERICK WADGE (NPI# 1043585326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043585326 |
| Entity Type | Individual |
| Full Name | DR. GORDON FREDERICK WADGE |
| Credential | M.D. |
| Practice Address |
120 Ochsner Blvd Ste 460 Gretna LA 70056-5282 |
| Mailing Address |
1514 Jefferson Highway New Orleans LA 70121-2429 |
| Practice Telephone | 5043719355 |
| Mailing Telephone | 5048424000 |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2019-07-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
MD.208087 | LA | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | MD.208087 | LA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2196537 | 05 | |
| MS | 06588588 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1514 Jefferson Hwy, Brent House Room 634, New Orleans, LA 701212429 | 5048423000 |
| Street Address |
120 OCHSNER BLVD STE 460 |
| City | GRETNA |
| State | LA |
| Zip Code | 70056-5282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669678892 | Updesh Bedi | Internal Medicine | 120 Ochsner Blvd Ste 460, Gretna, LA 70056-5282 | 2007-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023634169 | Krewe Wellness | Counselor | 2112 Belle Chasse Hwy Ste 8, #156, Gretna, LA 70056 | 2020-06-24 |
| 1205459732 | Gulf Coast Medical Specialists LLC | Internal Medicine | 1620 Belle Chasse Hwy Suite 101, Gretna, LA 70056 | 2020-05-19 |
| 1427530872 | Anna Marie Mckeon Jr. | Social Worker | 410 W. Butterfly Circle, Terrytown, LA 70056 | 2018-09-02 |
| 1558843219 | Nikell Thompson Fortia | Non-emergency Medical Transport (VAN) | 561 Morningside Dr, Gretna, LA 70056 | 2018-08-29 |
| 1861979379 | Irajuan L Cooley | Case Manager/Care Coordinator | 1620 Carol Sue Ave Apt 219, Gretna, LA 70056 | 2018-07-26 |
| 1457842528 | Veronica Stevenson | Case Manager/Care Coordinator | 1799 Stumpf Blvd Ste 4a, Terrytown, LA 70056 | 2018-05-24 |
| 1184126278 | Elesha Loston | Case Manager/Care Coordinator | 1799 Stumpf Blvd. Bldg .7 Suite 9a, Gretna, LA 70056 | 2018-03-05 |
| 1336656149 | Porsha D Causey | Counselor | 1799 Stumpf Blvd Bldg 7 Ste 10, Ste 10, Gretna, LA 70056 | 2018-01-02 |
| 1265950745 | Tamika Nicole Deville | Counselor | Advanced Therapeutic, 1799 Stumpf Blvd Bld 3 Ste 4b, Terrytown, LA 70056 | 2017-09-05 |
| 1679098792 | Clear Head Inc | Clinic/Center | 2310 Park Place Dr., Terrytown, LA 70056 | 2017-08-09 |
| Find all providers in zip 70056 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568404390 | Sophy Ann Jancich | Internal Medicine | 120 Ochsner Blvd Ste 310, Gretna, LA 70056 | 2006-06-13 |
| 1730379595 | Amanda D. Vuppala | Internal Medicine | 120 Meadowcrest Street, Gretna, LA 70056 | 2007-07-27 |
| 1184829665 | Hematology & Oncology Specialists LLC | Internal Medicine | 200 Lapalco Blvd, Suite 1c, Gretna, LA 70056-7113 | 2007-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659996544 | Bethesda Medical Clinic Infusion Center LLC | Internal Medicine | 1620 Belle Chasse Hwy Ste 102, Terrytown, LA 70056-7057 | 2020-06-16 |
| 1336528355 | Lafayette Health Ventures, Inc. | Internal Medicine | 814 Jefferson Ter, New Iberia, LA 70560-5727 | 2015-05-22 |
| 1821419334 | Beauregard Hematolog & Oncology | Internal Medicine | 301 S. Washington St., Ste B, Deridder, LA 70634 | 2013-12-31 |
| 1760758221 | Thomas Stewart Atkinson | Internal Medicine | 2121 Ridgelake Dr Fl 4, Metairie, LA 70001 | 2012-03-29 |
| 1548535883 | Aurash Khoobehi | Internal Medicine | 4204 Houma Blvd 2nd Floor, Ej Hem/onc, Metairie, LA 70006-2968 | 2012-03-20 |
| 1265713572 | Shaista H. Faruqui, M.d. Apmc | Internal Medicine | 5320 Dijon Dr, Baton Rouge, LA 70808-4313 | 2011-08-31 |
| 1437449949 | Tyler Donald Lash | Internal Medicine | 2600 Kings Hwy Ste 340, Shreveport, LA 71103-3951 | 2011-04-18 |
| 1700110632 | Marshall L Leary Jr Apmc | Internal Medicine | 1162 Oliver Road, Suite 7, Monroe, LA 71201 | 2009-09-24 |
| 1942478805 | Bridgette Collins Burow | Internal Medicine | 1430 Tulane Ave # Sl-78, New Orleans, LA 70112-2632 | 2008-02-13 |
| 1760687230 | Hematology & Specialists LLC | Internal Medicine | 506 Rue De Sante, La Place, LA 70068-5418 | 2007-06-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.