Provider Demographics
NPI:1750360954
Name:WELLONS, JAMES ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALAN
Last Name:WELLONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:ALAN
Other - Last Name:WELLONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9601 LILE DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6321
Mailing Address - Country:US
Mailing Address - Phone:501-224-2141
Mailing Address - Fax:501-224-0506
Practice Address - Street 1:9601 LILE DR
Practice Address - Street 2:SUITE 350
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6321
Practice Address - Country:US
Practice Address - Phone:501-224-2141
Practice Address - Fax:501-224-0506
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4425207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARB90666Medicare UPIN