Individual
MARK A WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2400 HARTMAN LN STE 100, SPRINGFIELD, OR 97477-1119
(541) 334-3350
(541) 746-4569
Mailing address
2400 HARTMAN LN, SPRINGFIELD, OR 97477-1118
(541) 334-3350
(541) 746-4569
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00800
OR
363AS0400X
Surgical Physician Assistant
PA00800
OR
Other
Enumeration date
11/21/2005
Last updated
09/28/2022
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