Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 04-32664 | KS |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 64053 | AZ |
N | 207QG0300X | Family Doctor - Geriatric Medicine | MD 12748 | KS |
NPI | 1083678650 |
---|---|
Provider Name | Dr. Austin Thomas Welsh |
First Address | Tucson, AZ 85712-2558 |
Second Address | Tucson, AZ 85712-2558 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 02/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1588844989 | BCBS OF KANSAS (01) | |
41-41155 | EVERCARE (01) | |
42128016 | BCBS OF KANSAS (01) | |
G07382 | (02) |