Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD470207 | PA |
NPI | 1023628666 |
---|---|
Provider Name | Dr. Jeffery Wells |
First Address | Hummelstown, PA 17036-8862 |
Second Address | Hershey, PA 17033-2360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2020 |
Last Update Date | 07/08/2020 |