MEDICARE: DR. JAMES ALAN WELLONS 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	207RN0300X	Nephrology Physician	C4425	AR

General Provider Information

NPI Number	:	1750360954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES ALAN WELLONS M.D.

Provider Business Mailing Address
First Line	:	9601 LILE DR
Second Line	:	SUITE 350
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-6321
Country	:	US
Telephone Number	:	501-224-2141
Fax Number	:	501-224-0506

Provider Business Practice Location Address
First Line	:	9601 LILE DR
Second Line	:	SUITE 350
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-6321
Country	:	US
Telephone Number	:	501-224-2141
Fax Number	:	501-224-0506

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

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	07/09/2007

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