Organization Active NPI

Gary B Wells MD, PLLC

  • Radiation Oncology Physician
  • Mountain Home, AR
National Provider Identifier
1811173263
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
N7796 Issued in AR
Legal business name
GARY B WELLS MD, PLLC
Practice address
628 Hospital Dr
Mountain Home, AR 72653-2953
Phone
(870) 424-2200
NPI assigned
Jan 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Gary B Wells, MD
Title
Owner
Phone
(870) 424-7070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X N7796 AR Primary

Addresses

Primary practice location

628 Hospital Dr
Mountain Home, AR 72653-2953

Mailing address

628 Hospital Dr
Mountain Home, AR 72653-2953
Phone (870) 424-2200

Other identifiers 1

IdentifierTypeStateIssuer
5F917OtherARBLUECROSS BLUE SHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1811173263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 HOSPITAL DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532953",
            "telephone_number": "870-424-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 HOSPITAL DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532953",
            "telephone_number": "870-424-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY B WELLS MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-424-7070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "AR",
            "license": "N7796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD",
            "identifier": "5F917",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.