WELLS MEDICAL CLINIC INC (NPI# 1780772780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780772780 |
| Entity Type | Organization |
| Organization Name | WELLS MEDICAL CLINIC INC |
| Practice Address |
407 East Calhoun St Bruce MS 38915 |
| Mailing Address |
Po Box 902 Bruce MS 38915 |
| Practice Telephone | 6629832151 |
| Practice Fax Number | 6629837151 |
| Mailing Telephone | 6629832151 |
| Mailing Fax Number | 6629837151 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | WILLIE L WELLS (PRESIDENT OF WELLS MEDICAL CLINIC) |
| Authorized Official Telephone | 6629832151 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 09661 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09015158 | 05 |
| Street Address |
407 EAST CALHOUN ST |
| City | BRUCE |
| State | MS |
| Zip Code | 38915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841315678 | Willie L Wells | Family Medicine | 407 East Calhoun St, Bruce, MS 38915 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396286456 | Reconnect Wellness Bruce LLC | Preferred Provider Organization | 131 Public Square, Bruce, MS 38915 | 2017-03-09 |
| 1710286356 | Damon Doler | Physical Therapist | 176 Hwy 9, Bruce, MS 38915 | 2011-03-22 |
| 1124332135 | Anna Claire Jefcoat | Physical Therapy Assistant | 176 Highway 9 N, Bruce, MS 38915 | 2010-08-02 |
| 1487968574 | Elizabeth Kavanagh | Physical Therapist | 176 Hwy 9 North, Bruce, MS 38915 | 2010-07-30 |
| 1851611974 | Becky F. Butts | Speech-Language Pathologist | 176 Hwy 9 N, Bruce, MS 38915 | 2010-06-11 |
| 1013048453 | Bruce Nursing Center, Inc. | Nursing Facility/Intermediate Care Facility | 176 Hwy 9 South, Bruce, MS 38915 | 2007-03-08 |
| 1851477079 | Tom B Longest Jr. | Family Medicine | 128 Public Square, Bruce, MS 38915 | 2006-10-31 |
| 1588681050 | Freds Stores of Tennessee Inc | Pharmacy | 403 W Calhoun Street, Bruce, MS 38915 | 2006-07-17 |
| 1891334702 | Tiffany Palertree Moore | Speech-Language Pathologist | 131 Public Square, Bruce, MS 38915 | 2019-12-26 |
| 1336652841 | Cortney Stieffel | Speech-Language Pathologist | 176 Hwy 9 North, Bruce, MS 38915 | 2017-11-07 |
| Find all providers in zip 38915 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407901267 | James L. Ziobron | Family Medicine | 71441 Van Dyke Rd, Bruce, MI 48065-3808 | 2007-01-24 |
| 1851477079 | Tom B Longest Jr. | Family Medicine | 128 Public Square, Bruce, MS 38915 | 2006-10-31 |
| 1184696700 | Arti Bajpai | Family Medicine | 80650 Van Dyke Rd, Bruce, MI 48065-1333 | 2006-02-07 |
| 1841315678 | Willie L Wells | Family Medicine | 407 East Calhoun St, Bruce, MS 38915 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900581 | Maegan Cook Bridges | Family Medicine | 312 Ridge Pointe Dr, Brandon, MS 39042-5035 | 2020-10-24 |
| 1003415266 | Christian Fortenberry | Family Medicine | 786 Lake Harbour Dr, Ridgeland, MS 39157-4303 | 2020-10-20 |
| 1457967226 | Tiffine Lynn Prisock | Family Medicine | 24978 Ms-15, Mathiston, MS 39752 | 2020-09-17 |
| 1851902860 | Jasmine Lester | Family Medicine | 538 Getwell Rd S, Hernando, MS 38632-9585 | 2020-08-12 |
| 1942810569 | Ericka Marcene Williams | Family Medicine | 1031 Northridge Rd Ste A, Baldwyn, MS 38824-1173 | 2020-08-07 |
| 1316557986 | Independent Healthcare Management, Inc | Family Medicine | 376 Simpson Highway 149 Ste 600, Magee, MS 39111-3572 | 2020-08-07 |
| 1164031373 | Rohith Reddy Guduru Venkata | Family Medicine | Delta Regional Medical Center, 1400 E Union St, Greenville, MS 38703 | 2020-07-24 |
| 1831707470 | Rebecca Holmes | Family Medicine | 42 Atley Holmes Rd # Rs, Jayess, MS 39641-8272 | 2020-07-20 |
| 1497373344 | Dhruval Patel | Family Medicine | 564 Cypress Ln Apt 11d, Greenville, MS 38701-7415 | 2020-07-08 |
| 1881211258 | Tiffany Chapman | Family Medicine | 905 S Frontage Rd, Meridian, MS 39301-6113 | 2020-07-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on WELLS MEDICAL CLINIC 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.