Individual
DR. EDWARD HUNTER WELLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 SKYLINE DRIVE, JACKSON, TN 38301-3901
(731) 660-8759
Mailing address
1947A MADISON ST, CLARKSVILLE, TN 37043-5066
(931) 647-5034
(931) 552-6663
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD06885
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300056942
RAILROAD MEDICARE
—
01
—
3057437
BCBS
—
05
—
3328417
—
TN
05
—
3328418
—
TN
01
—
4102528
BCBS
—
Enumeration date
03/02/2006
Last updated
07/20/2009
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