Individual
DR. JACK CODY WELLS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
551 VETERANS UNITED DR, COLUMBIA, MO 65201-8397
(573) 884-7733
(573) 882-6228
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R4G70
MO
207Q00000X
Family Medicine Physician
Primary
R4G70
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209804624
—
MO
Enumeration date
02/15/2006
Last updated
08/15/2024
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