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Organization

GARY B WELLS MD, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GARY B WELLS MD (OWNER)
(870) 424-7070
Entity
Organization

Contact information

Practice address
628 HOSPITAL DR, MOUNTAIN HOME, AR 72653-2953
(870) 424-2200
Mailing address
628 HOSPITAL DR, MOUNTAIN HOME, AR 72653-2953
(870) 424-2200

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
N7796
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5F917
BLUECROSS BLUE SHIELD
AR
Enumeration date
01/16/2008
Last updated
02/26/2008
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