Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wade Wyckoff

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1689243149

Wade Wyckoff is a Physical Medicine and Rehabilitation in Shreveport, Louisiana. Qualified in 2021, 5 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
5
Licensed in
LA
In the registry since
2021

Practice location Address checks out

1111 Line Ave
Shreveport, LA 71101-3841
Phone: (318) 716-4545
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 346157 (LA)

Record details

NPI number1689243149
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 20, 2021
Last updated in NPPESOctober 14, 2025
Certification dateOctober 14, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Shreveport