MEDICARE: DR. JOSEPH JOHN 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	2080A0000X	Pediatric Adolescent Medicine Physician	15915	AZ
2	208000000X	Pediatrics Physician	15915	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	770903	OTHER	AZ	UNITED HEALTHCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	85031A005	OTHER	AZ	TRICARE
4	AZ189960	OTHER	AZ	BCBS
5	1Z8747	OTHER	AZ	HEALTHNET

General Provider Information

NPI Number	:	1902802168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH JOHN WELLS M.D.

Provider Business Mailing Address
First Line	:	4700 N 51ST AVE
Second Line	:	STE 4
City	:	PHOENIX
State	:	AZ
Zip	:	85031-1237
Country	:	US
Telephone Number	:	623-846-7575
Fax Number	:	623-247-6386

Provider Business Practice Location Address
First Line	:	4700 N 51ST AVE
Second Line	:	STE 4
City	:	PHOENIX
State	:	AZ
Zip	:	85031-1237
Country	:	US
Telephone Number	:	623-846-7575
Fax Number	:	623-247-6386

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	02/06/2025

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Directions to “ DR. JOSEPH JOHN WELLS M.D.” Practice Location

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