Individual
ROGER D WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1201 N ERIE ST, LEXINGTON, NE 68850-1571
(308) 324-5651
Mailing address
PO BOX 980, LEXINGTON, NE 68850-0980
(308) 324-5651
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
376
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70005753
RAILROAD MEDICARE
NE
Enumeration date
12/21/2005
Last updated
08/28/2019
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