Provider Demographics
NPI:1952625808
Name:MY WELL CARE
Entity type:Organization
Organization Name:MY WELL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLARISSA
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:ARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-833-6898
Mailing Address - Street 1:PO BOX 58793
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-8793
Mailing Address - Country:US
Mailing Address - Phone:615-833-6898
Mailing Address - Fax:615-833-6895
Practice Address - Street 1:2275 MURFREESBORO PIKE
Practice Address - Street 2:STE 109 & 110
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-3341
Practice Address - Country:US
Practice Address - Phone:615-833-6898
Practice Address - Fax:615-833-6895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-22
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty