MEDICARE: DR. JOHN J WELLS MD

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	174400000X	Specialist	14097	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	110639	OTHER	AZ	PIN NUMBER FOR OUT PATIEN

General Provider Information

NPI Number	:	1043214422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN J WELLS MD

Provider Business Mailing Address
First Line	:	3020 E CAMELBACK RD
Second Line	:	SUITE 301
City	:	PHOENIX
State	:	AZ
Zip	:	85014-5095
Country	:	US
Telephone Number	:	602-264-9100
Fax Number	:	602-264-9101

Provider Business Practice Location Address
First Line	:	3815 E BELL RD
Second Line	:	STE 1250
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2122
Country	:	US
Telephone Number	:	602-493-3030
Fax Number	:	602-493-0064

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	02/17/2017

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Directions to “ DR. JOHN J WELLS MD” Practice Location

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