WELL LIFE FAMILY MEDICINE INC (NPI# 1063903748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063903748 |
| Entity Type | Organization |
| Organization Name | WELL LIFE FAMILY MEDICINE INC |
| Practice Address |
1623 Rogers Ave Fort Smith AR 72901-3826 |
| Practice Telephone | 4797826318 |
| Practice Fax Number | 4797827028 |
| Mailing Telephone | 4797826318 |
| Mailing Fax Number | 4797827028 |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2018-05-29 |
| Authorized Official Name | DR. BRYAN K LEDBETTER (D.O./ OWNER) |
| Authorized Official Telephone | 4797826318 |
| Authorized Official Credential | D.O.,MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | T2018-104 | AR | Allopathic & Osteopathic Physicians |
| Street Address |
1623 ROGERS AVE |
| City | FORT SMITH |
| State | AR |
| Zip Code | 72901-3826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750381489 | Carol L Erwin | Nurse Practitioner | 1623 Rogers Ave, Fort Smith, AR 72901 | 2005-07-22 |
| 1114982345 | Ngoc Van Hoang | General Practice | 1623 Rogers Ave, Fort Smith, AR 72901-3826 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922627249 | Vaibhav S Desai | Student in an Organized Health Care Education/Training Program | Family Medicine Uams-west, 612 South 12th St., Fort Smith, AR 72901 | 2020-04-16 |
| 1689136475 | Prudence Nassem Ipaye-adebiyi | Student in an Organized Health Care Education/Training Program | Family Medicine ; Uams-west, 612 South 12th St., Fort Smith, AR 72901 | 2019-04-02 |
| 1134608961 | Baptist Health Services | Otolaryngology | 520 Towson Ave, Suite A, Fort Smith, AR 72901 | 2018-08-13 |
| 1316426125 | Baptist Health Services | Internal Medicine | 1500 Dodson Ave Ste 60, Fort Smith, AR 72901 | 2018-08-13 |
| 1396224101 | Baptist Health Services | Internal Medicine | 1001 Towson Ave Ste 100, Fort Smith, AR 72901 | 2018-08-13 |
| 1164901914 | Baptist Health Services | Internal Medicine | 1001 Towson Ave Ste 200, Fort Smith, AR 72901 | 2018-08-13 |
| 1942789755 | Baptist Health Services | Counselor | 1001 Towson Ave Ste 500, Fort Smith, AR 72901 | 2018-08-13 |
| 1669951315 | Baptist Health Services | Family Medicine | 1500 Dodson Ave Ste 175, Fort Smith, AR 72901 | 2018-08-13 |
| 1508345265 | Baptist Health Services | Internal Medicine | 1500 Dodson Ave Ste 180, Fort Smith, AR 72901 | 2018-08-13 |
| 1326527086 | Baptist Health Services | Family Medicine | 1500 Dodson Ave Ste 195, Fort Smith, AR 72901 | 2018-08-13 |
| Find all providers in zip 72901 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003360082 | Healthmax Center LLC | General Practice | 12300 Highway 71 S, Suite A, Fort Smith, AR 72916-9133 | 2016-08-08 |
| 1538572227 | South Central Medical Services, P.a. | General Practice | 3401 Rogers Ave, Suite C, Fort Smith, AR 72903-2956 | 2014-06-10 |
| 1114982345 | Ngoc Van Hoang | General Practice | 1623 Rogers Ave, Fort Smith, AR 72901-3826 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790382059 | Landmark Medical of Arkansas Pa | General Practice | 425 W Capitol Ave Ste 425, Little Rock, AR 72201-3424 | 2020-10-08 |
| 1306480231 | Command Radiology Solutions, Inc. | General Practice | 3708 Pilot Grove Loop, Ozark, AR 72949-2488 | 2019-11-04 |
| 1215586797 | Achor Management Inc | General Practice | 1900 Club Manor Dr Ste 101a, Maumelle, AR 72113-7443 | 2019-09-08 |
| 1093364820 | Center for Regenerative Medicine Pa | General Practice | 9307 Maumelle Blvd, North Little Rock, AR 72113-6609 | 2019-09-04 |
| 1083269690 | University of Arkansas At Monticello | General Practice | 663 University Drive, Monticello, AR 71656 | 2019-08-09 |
| 1912492786 | Chelsea Brown | General Practice | 6309 Highway 5 N, Bryant, AR 72022-8506 | 2018-06-25 |
| 1205345154 | Lakeside Walk-in Clinic Pllc | General Practice | 2230 Malvern Ave Ste E, Hot Springs, AR 71901-8000 | 2017-09-22 |
| 1558897595 | Epoch-nwa Pllc | General Practice | 5100 W Pauline Whitaker Pkwy, Ste. 110, Rogers, AR 72758-8335 | 2017-05-11 |
| 1023540655 | Aaron M Smith | General Practice | Varner Unit State Hwy 388, Gould, AR 71643 | 2017-04-02 |
| 1942749148 | Reece Lewis Crow | General Practice | 34 Windsor Road, Little Rock, AR 72212 | 2017-02-21 |
| Find all providers with the same taxonomy | ||||
| City | FORT SMITH |
| Zip Code | 72901 |
Please comment or provide details below to improve the information on WELL LIFE FAMILY MEDICINE INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.