# MEDWELL LLC

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

## Provider details

- **NPI number:** 1356756936
- **Authorized official:** MR. JOHN M EBY (PRESIDENT)
- **Authorized official phone:** (602) 679-7676

## Contact information

- **Practice address:** 610 N GILBERT RD, SUITE 309, GILBERT, AZ 85234-4502
- **Practice address phone:** (480) 926-1111
- **Practice address fax:** (480) 926-2958
- **Mailing address:** 610 N GILBERT RD, SUITE 309, GILBERT, AZ 85234-4502
- **Mailing address phone:** (480) 926-1111
- **Mailing address fax:** (480) 926-2958

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/23/2014
- **Last updated:** 06/23/2014