MEDICARE: SPENCER G WELLS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	43392	KY
2	207L00000X	Anesthesiology Physician	43392	KY
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	13878	NV
4	207LP2900X	Pain Medicine (Anesthesiology) Physician	4822810-1205	UT

General Provider Information

NPI Number	:	1023151644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SPENCER G WELLS M.D.

Provider Business Mailing Address
First Line	:	617 E RIVERSIDE DR STE 301
Second Line	:
City	:	SAINT GEORGE
State	:	UT
Zip	:	84790-8722
Country	:	US
Telephone Number	:	435-216-7000
Fax Number	:	435-216-7001

Provider Business Practice Location Address
First Line	:	617 E RIVERSIDE DR STE 301
Second Line	:
City	:	SAINT GEORGE
State	:	UT
Zip	:	84790-8722
Country	:	US
Telephone Number	:	435-216-7000
Fax Number	:	435-216-7001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	03/29/2023

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Directions to “ SPENCER G WELLS M.D.” Practice Location

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