Wells, Peggy J
Wells, Peggy J is an individual health care provider with primary practice located at 2245 N State St , Clarksdale MS 38614. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wells, Peggy J can be contacted via phone (662) 627-4131.Contact Information
Primary practice address
2245 N State St
Clarksdale MS 38614
Phone: (662) 627-4131
Fax: (662) 627-2702
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 07070 | Mississippi |
Profile Details
| NPI number | 1710001482 |
|---|---|
| LBN Legal business name | Wells, Peggy J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 19th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710001482 | NPPES |
| Mississippi | MEDICAID | 00114187 | |
| Mississippi | MEDICAID | 113143001 |
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