Provider Demographics
NPI:1407881253
Name:WELLS, DUNCAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DUNCAN
Middle Name:
Last Name:WELLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 WOODSTOCK PKWY STE 310
Mailing Address - Street 2:SUITE 310
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-4869
Mailing Address - Country:US
Mailing Address - Phone:770-517-2257
Mailing Address - Fax:877-447-4190
Practice Address - Street 1:970 WOODSTOCK PKWY STE 310
Practice Address - Street 2:SUITE 310
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-4869
Practice Address - Country:US
Practice Address - Phone:770-517-2257
Practice Address - Fax:877-447-4190
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA041386207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA20BDCTFOtherPTAN
GAGRP4627OtherPTAN
GAGRP4627OtherPTAN