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Individual

BRADLEY E WELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
911 BYPASS RD, PIKEVILLE, KY 41501-1689
(606) 432-1357
(606) 432-2457
Mailing address
PO BOX 2648, PIKEVILLE, KY 41502-2648
(606) 432-1357
(606) 432-2457

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
46005
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000821046
ANTHEM
KY
01
1427202621
VIRGINIA MEDICAID
VA
05
7100241640
KY
01
K091710
MEDICARE
KY
01
P01223063
RAILROAD MEDICARE
KY
Enumeration date
11/14/2008
Last updated
11/11/2013
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