| Doctor Name: | DR. KEVIN W WELLS |
| NPI Number: | 1194809178 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OD |
| License Number: | 2263 |
| Business Practice Address: | 4012 Commons Dr W Ste 110 Destin, FL - 325418422 |
| Business Phone Number: | 5802235300 |
| Business Fax Number: | 5802235356 |
| Mailing Address: | 4012 Commons Dr W, Suite 110 DESTIN |
| State: | FL |
| Postal Code: | 325418422 |
| Phone Number: | 5802235300 |
| Fax Number: | 5802235356 |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 11/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WC0802X |
| License Number: | 2263 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Corneal and Contact Management |
| Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |