Organization
PENNYRILE GENERAL & WEIGHT LOSS SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERAME T WELLS MD (SOLE MEMBER)
(270) 887-0278
Entity
Organization
Contact information
Practice address
320 W 18TH ST, HOPKINSVILLE, KY 42240-1965
(270) 632-4555
(270) 632-4556
Mailing address
PO BOX 2400, HOPKINSVILLE, KY 42241-2400
(270) 632-4555
(270) 632-4556
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100223340
—
KY
Enumeration date
09/20/2012
Last updated
04/11/2014
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