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General NPI Number Information
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NPI Number | 1427202621
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Entity Type | Individual
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Provider Name | BRADLEY E WELLS M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 11/11/2013
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Provider Practice Location Address
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Address Line | 911 BYPASS RD
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City | PIKEVILLE
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State | KY
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Zip | 41501-1689
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Country | US
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Telephone | 606-432-1357
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Fax | 606-432-2457
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Provider Business Mailing Address
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Address Line | PO BOX 2648
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City | PIKEVILLE
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State | KY
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Zip | 41502-2648
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Country | US
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Telephone | 606-432-1357
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Fax | 606-432-2457
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 46005
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License Number State | KY
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