Individual
JOHN SPENCER WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
250 W 300 N, ROOSEVELT, UT 84066-2336
(435) 722-4691
(435) 722-9291
Mailing address
250 W 300 N, ROOSEVELT, UT 84066-2336
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11014440A
IN
207Q00000X
Family Medicine Physician
Primary
7906638-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11014440A
RESIDENCY PERMIT #
IN
01
—
7906638-1205
STATE LICENCE
UT
Enumeration date
06/13/2008
Last updated
06/28/2017
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