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NPI Code Detail

MEDICARE: DR. RANDALL HAL WELLS M.D.

MEDICARE: DR. RANDALL HAL 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
12084P0800XPsychiatry PhysicianC-5671AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245290816
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDALL HAL WELLS M.D.
Provider Business Mailing Address
First Line : 105 RESERVE ST
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71901-4195
Country : US
Telephone Number : 501-624-4411
Fax Number : 501-624-0019
Provider Business Practice Location Address
First Line : 105 RESERVE ST
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71901-4195
Country : US
Telephone Number : 501-624-4411
Fax Number : 501-624-0019
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2006
Last Update Date : 01/20/2012

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Directions to “ DR. RANDALL HAL WELLS M.D.” Practice Location

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