Organization Name: | J. DARRICK WELLS, MD, INC |
NPI Number: | 1811061773 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES DARRICK WELLS (PRESIDENT) |
Mailing Address: | 1201 Rose Ave Selma |
State: | CA US |
Postal Code: | 936623227 |
Phone Number: | 5598912333 |
Fax Number: | |
NPI Enumeration Date: | 11/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G078059 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |