Healthcare Provider Details

I. General information

NPI: 1356399620
Provider Name (Legal Business Name): ORLANDIS L. WELLS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9065 S PECOS RD STE 240
HENDERSON NV
89074-7189
US

IV. Provider business mailing address

PO BOX 530124
HENDERSON NV
89053-0124
US

V. Phone/Fax

Practice location:
  • Phone: 702-568-6108
  • Fax: 702-487-5773
Mailing address:
  • Phone: 702-568-6108
  • Fax: 702-568-8603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number10558
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: