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Individual

MR. GARY B WELLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
624 HOSPITAL DRIVE, MOUNTAIN HOME, AR 72653-2915
(870) 424-2200
(870) 424-6616
Mailing address
PO BOX 1268, MOUNTAIN HOME, AR 72654-1268
(870) 424-7070
(870) 424-6616

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
N-7796
AR
2085R0001X
Radiation Oncology Physician
N7796
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
115858001
AR
Enumeration date
05/19/2006
Last updated
06/06/2016
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