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General NPI Number Information
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NPI Number | 1134234859
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Entity Type | Individual
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Provider Name | ALVIN F WELLS MD
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Gender | Male
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 137 CRYSTAL BEACH DR STE 121
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City | DESTIN
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State | FL
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Zip | 32541-3573
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Country | US
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Telephone | 850-807-4388
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Fax | 850-862-3979
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Provider Business Mailing Address
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Address Line | 917 MAR WALT DR
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-6651
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Country | US
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Telephone | 850-862-3979
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Fax | 850-862-0605
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 46013
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | ME169775
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License Number State | FL
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