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General NPI Number Information
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NPI Number | 1376820050
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Entity Type | Organization
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Legal Business Name | ERIC B. WELLS MD, LLC
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Dates
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Enumeration Date | 11/09/2011
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 207A LONGWOOD DR SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5243
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Country | US
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Telephone | 256-489-6501
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Fax | 256-489-6503
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Provider Business Mailing Address
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Address Line | 207A LONGWOOD DR SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5243
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Country | US
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Telephone | 256-489-6501
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Fax | 256-489-6503
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ERIC WELLS
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Credential | M.D.
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Telephone | 256-489-6501
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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 | MD31199
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License Number State | AL
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