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Jeremy Blake Wells

Family Doctor Family Doctor - Sports Medicine

103 Medical Park
Hattiesburg , Mississippi 39401-9042

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Jeremy Blake Wells

Family Doctor Family Doctor - Sports Medicine

103 Medical Park
Hattiesburg , Mississippi 39401-9042

(601) 579-5240

Write a Review Save Call

Jeremy Blake Wells

Family Doctor Family Doctor - Sports Medicine

103 Medical Park
Hattiesburg , Mississippi 39401-9042

(601) 579-5240 Call

Write a Review Save

About


Features

Language(s) Spoken
English
Ethnic Identity
White / Caucasian

Specialties

  • Family Doctor
  • Family Doctor - Sports Medicine

Languages spoken

  • English

Location

103 Medical Park Hattiesburg , Mississippi 39401-9042

First Address

  • Jeremy Blake Wells
  • 415 S 28th Ave
  • Hattiesburg, MS
  • Zip : 39401-7246
  • Fax : (601) 579-5240
  • Phone : (601) 268-5630

Second Address

  • Jeremy Blake Wells
  • 103 Medical Park
  • Hattiesburg, MS
  • Zip : 39401-9042
  • Fax : (601) 268-5819
  • Phone : (601) 268-5630

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FAQs


Where did Jeremy Blake Wells attend graduate school?

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Where did Jeremy Blake Wells do his residency?

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Where did Jeremy Blake Wells do his fellowship?

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Is Jeremy Blake Wells board certified?

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What type of doctor is Jeremy Blake Wells

Family Doctor - Sports Medicine

In what state does Jeremy Blake Wells practice in?

Mississippi

Where is Jeremy Blake Wells ’s practice located?

103 Medical Park , Hattiesburg, Mississippi, 39401-9042

What is Jeremy Blake Wells ’s gender?

Male

Is Jeremy Blake Wells a sole practitioner?

No

Is Jeremy Blake Wells accepting new patients?

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What languages does Jeremy Blake Wells speak?

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Does Jeremy Blake Wells accept insurance?

Yes, Jeremy Blake Wells accepts insurance

Does Jeremy Blake Wells offers telemedicine?

Jeremy Blake Wells has not indicated if he offers telemedicine

What is Jeremy Blake Wells ’s professional license number?

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What is Jeremy Blake Wells ’s NPI number?

1144517822

Does Jeremy Blake Wells have any license restrictions?

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Scope of Practice

Primary Taxonomy Code Taxonomy Specialty License Number License State
N 207Q00000X Family Doctor T-2501 MS
Y 207QS0010X Family Doctor - Sports Medicine 22493 MS

National Provider Identifier

NPI 1144517822
Provider Name Jeremy Blake Wells
First Address Hattiesburg, MS 39401-7246
Second Address Hattiesburg, MS 39401-9042
Gender M
NPI Entity type Individual
Is Sole Proprietor No
Is Organization Subpart N/A
Enumeration Date 01/07/2011
Last Update Date 21/07/2020

Additional Identifiers

IDENTIFIER TYPE / CODE IDENTIFIER STATE
06927265 (05) MS

NPI Footnotes


What is the National Provider Identifier (NPI)

The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address

The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address

The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code

The code describing the type of health care provider that is being assigned an NPI. The entity type codes are:
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?

Subparts are the components and separate physical locations of organization health care providers. Subpart examples include: Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name

The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.

Provider Enumeration Date

The date the provider was assigned a unique identifier (assigned an NPI)

Last Update Date

The date that a NPI record was last updated or changed

Primary Taxonomy Code

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPls the license data is associated to the taxonomy code.

Authorized Official Name

The name of the person authorized to submit the PI application or to officially change data for a health care provider.

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