# WELL LIFE FAMILY MEDICINE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063903748
- **Authorized official:** DR. BRYAN K LEDBETTER D.O.,MBA (D.O./ OWNER)
- **Authorized official phone:** (479) 782-6318

## Contact information

- **Practice address:** 1623 ROGERS AVE, FORT SMITH, AR 72901-3826
- **Practice address phone:** (479) 782-6318
- **Practice address fax:** (479) 782-7028
- **Mailing address:** 1623 ROGERS AVE, FORT SMITH, AR 72901-3826
- **Mailing address phone:** (479) 782-6318
- **Mailing address fax:** (479) 782-7028

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | T2018-104 | AR | Yes |

## Other

- **Enumeration date:** 05/29/2018
- **Last updated:** 05/29/2018