MEDICARE: WELL LIFE FAMILY MEDICINE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	T2018-104	AR

General Provider Information

NPI Number	:	1063903748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELL LIFE FAMILY MEDICINE INC

Provider Business Mailing Address
First Line	:	1623 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-3826
Country	:	US
Telephone Number	:	479-782-6318
Fax Number	:	479-782-7028

Provider Business Practice Location Address
First Line	:	1623 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-3826
Country	:	US
Telephone Number	:	479-782-6318
Fax Number	:	479-782-7028

Authorized Official
Title or Position	:	D.O./ OWNER
Name	:	DR. BRYAN K LEDBETTER
Credential	:	D.O.,MBA
Telephone Number	:	479-782-6318

Provider Enumeration Date	:	05/29/2018
Last Update Date	:	05/29/2018

Similar Medicare Providers

1073953543 — BRIAN HEALY LMT,AP,DOM
Practice Location Address:

16680 MCGREGOR BLVD STE 2
FORT MYERS, FL
33908-3826

Practice Phone: 239-395-1100
Practice Fax: 866-936-4172

1639503899 — SANIBEL WELLNESS
Practice Location Address:

16680 MCGREGOR BLVD STE 2
FORT MYERS, FL
33908-3826

Practice Phone: 239-395-1100
Practice Fax:

1265016505 — SHEILA GLAZER RD
Practice Location Address:

2100 S OCEAN LN APT 1411
FORT LAUDERDALE, FL
33316-3826

Practice Phone: 561-289-5682
Practice Fax:

1184300485 — ITDV NON EMERGENCY TRANSPORTATION INC
Practice Location Address:

1872 SW 29TH AVE
FORT LAUDERDALE, FL
33312-3826

Practice Phone: 954-348-5501
Practice Fax:

1164239190 — JAEKILLA WALLS
Practice Location Address:

2275 CENTRAL AVE APT 46
FORT MYERS, FL
33901-3826

Practice Phone: 239-391-5939
Practice Fax:

1164375424 — LAVENDER OF FORT SMITH
Practice Location Address:

1500 FRESNO ST
FORT SMITH, AR
72901-7023

Practice Phone: 479-785-5544
Practice Fax:

Directions to “WELL LIFE FAMILY MEDICINE INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.