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General NPI Number Information
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NPI Number | 1073943171
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Entity Type | Organization
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Legal Business Name | HOMEBOUND PHYSICIAN SERVICES, PLLC
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Dates
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Enumeration Date | 11/26/2013
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | 101 W GRUNDY AVE
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City | SPRINGFIELD
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State | KY
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Zip | 40069-1411
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Country | US
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Telephone | 859-336-1247
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Fax | 866-408-2390
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Provider Business Mailing Address
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Address Line | 101 W GRUNDY AVE
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City | SPRINGFIELD
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State | KY
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Zip | 40069-1411
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Country | US
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Telephone | 859-336-1247
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Fax | 866-408-2390
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN F WELLS
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Credential | MD
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Telephone | 859-336-1247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 21969
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License Number State | KY
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