Individual
DR. WILLIAM JACOB WELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7545 AIRWAYS BLVD, SOUTHAVEN, MS 38671-5806
(901) 759-3100
Mailing address
1400 S GERMANTOWN RD, GERMANTOWN, TN 38138-2205
(901) 759-3100
(901) 759-3196
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
57285
TN
207XS0106X
Orthopaedic Hand Surgery Physician
W0328
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00956761
—
MS
05
—
100231278
—
MS
05
—
Q045692
—
TN
Enumeration date
06/06/2012
Last updated
08/07/2025
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