Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 59134 | TN |
NPI | 1093159436 |
---|---|
Provider Name | Daniel Benjamin Wells |
First Address | Knoxville, TN 37930-2569 |
Second Address | Knoxville, TN 37916-2435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2013 |
Last Update Date | 02/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q048799 | (05) | TN |