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Individual

JOHN W. WELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5379
(740) 446-5883
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5379
(740) 446-5883

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50001045
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0075759
OH
05
0113223000
WV
01
310917085305
CARESOURCE
OH
01
970013460
RR MEDICARE
OH
Enumeration date
07/20/2006
Last updated
01/11/2021
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