Individual
JOHN W WELLS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3599 UNIVERSITY BLVD S, BLDG 100, SUITE 104, JACKSONVILLE, FL 32216-4252
(904) 391-1100
(904) 391-1109
Mailing address
PO BOX 19675, JACKSONVILLE, FL 32245-9675
(904) 309-8680
(904) 345-5841
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME 39415
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208063
AVMED
FL
01
—
53630
BCBS
FL
05
—
O42404800
—
FL
01
—
P00199547
MEDICARE RAILROAD
FL
Enumeration date
11/04/2005
Last updated
07/31/2012
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