Individual
PHILLIP KEVIN WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
222 PERRY HWY, HAWKINSVILLE, GA 31036-6748
(478) 783-0200
(478) 783-0802
Mailing address
PO BOX 1297, HAWKINSVILLE, GA 31036-7297
(478) 892-0530
(478) 783-0802
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
052653
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
360737730A
—
GA
Enumeration date
06/22/2005
Last updated
09/09/2009
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