Jeremy Blake Wells
Family Doctor Family Doctor - Sports Medicine
103 Medical Park
Hattiesburg
, Mississippi 39401-9042
Jeremy Blake Wells
Family Doctor Family Doctor - Sports Medicine
103 Medical Park
Hattiesburg
, Mississippi 39401-9042
(601) 579-5240
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About
Features
Specialties
- Family Doctor
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
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
Reviews
FAQs
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What type of doctor is Jeremy Blake Wells
In what state does Jeremy Blake Wells practice in?
Where is Jeremy Blake Wells ’s practice located?
What is Jeremy Blake Wells ’s gender?
Is Jeremy Blake Wells a sole practitioner?
Is Jeremy Blake Wells accepting new patients?
What languages does Jeremy Blake Wells speak?
Does Jeremy Blake Wells accept insurance?
Does Jeremy Blake Wells offers telemedicine?
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What is Jeremy Blake Wells ’s NPI number?
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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)
Provider Location Address
Provider Mailing Address
Entity Type Code
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?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.