# WELLSPRING PHYSICIAN, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wellspring Physician, P.C. (AK)
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457898660
- **Authorized official:** KATHRYN J SOWERWINE MD (CMO)
- **Authorized official phone:** (979) 221-1398

## Contact information

- **Practice address:** 8585 OLD DAIRY RD STE 208, JUNEAU, AK 99801-8094
- **Practice address phone:** (877) 872-0370
- **Practice address fax:** (855) 908-2520
- **Mailing address:** 4359 ROANS CHAPEL RD, COLLEGE STATION, TX 77845-4096

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | NULL | — |
| 207K00000X | Allergy & Immunology Physician | — | — | — |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 01/25/2017
- **Last updated:** 07/28/2026