Provider Demographics
NPI:1437104007
Name:WELLS, ROBERT THAXTON (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:THAXTON
Last Name:WELLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2708 RIFE MEDICAL LN
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1452
Mailing Address - Country:US
Mailing Address - Phone:479-338-3030
Mailing Address - Fax:479-338-3079
Practice Address - Street 1:2708 RIFE MEDICAL LN
Practice Address - Street 2:SUITE 300
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1452
Practice Address - Country:US
Practice Address - Phone:479-338-3030
Practice Address - Fax:479-338-3079
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-8202207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology