# WELLS MEDICAL CLINIC INC

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

## Provider details

- **NPI number:** 1780772780
- **Authorized official:** WILLIE L WELLS MD (PRESIDENT OF WELLS MEDICAL CLINIC)
- **Authorized official phone:** (662) 983-2151

## Contact information

- **Practice address:** 407 EAST CALHOUN ST, BRUCE, MS 38915
- **Practice address phone:** (662) 983-2151
- **Practice address fax:** (662) 983-7151
- **Mailing address:** PO BOX 902, BRUCE, MS 38915
- **Mailing address phone:** (662) 983-2151
- **Mailing address fax:** (662) 983-7151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 09661 | MS | Yes |

## Other

- **Enumeration date:** 10/11/2006
- **Last updated:** 08/22/2020