Provider Demographics
NPI:1700345758
Name:WELLS, JOSHUA
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:WELLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LCMC HEALTH - PAYOR ENROLLMENTS
Mailing Address - Street 2:1100 POYDRAS ST., 2500 ENERGY CENTRE
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70163-2500
Mailing Address - Country:US
Mailing Address - Phone:504-527-9953
Mailing Address - Fax:504-527-9950
Practice Address - Street 1:4228 HOUMA BLVD STE 410
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-3021
Practice Address - Country:US
Practice Address - Phone:504-883-3770
Practice Address - Fax:504-883-3711
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA337943207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program