Provider Demographics
NPI:1093819799
Name:WADE-HAMME, JOYCE DEANETTE (MD)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:DEANETTE
Last Name:WADE-HAMME
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 LAKELAND DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-7640
Mailing Address - Country:US
Mailing Address - Phone:601-326-2599
Mailing Address - Fax:601-933-0852
Practice Address - Street 1:2506 LAKELAND DR STE 300
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7640
Practice Address - Country:US
Practice Address - Phone:601-326-2599
Practice Address - Fax:601-933-0852
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16754207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00122170Medicaid
MS0122170Medicaid
G44722Medicare UPIN
MS0122170Medicaid
MSG44722Medicare PIN
G44722Medicare UPIN