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Organization

WELLS MEDICAL CLINIC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIE L WELLS MD (PRESIDENT OF WELLS MEDICAL CLINIC)
(662) 983-2151
Entity
Organization

Contact information

Practice address
407 EAST CALHOUN ST, BRUCE, MS 38915
(662) 983-2151
(662) 983-7151
Mailing address
PO BOX 902, BRUCE, MS 38915
(662) 983-2151
(662) 983-7151

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
09661
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09015158
MS
Enumeration date
10/11/2006
Last updated
08/22/2020
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