Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 15430 | NE |
Y | 207WX0107X | Retina Specialist | 15430 | NE |
NPI | 1033116074 |
---|---|
Provider Name | Dr. John C Welch |
First Address | Hastings, NE 68901-9160 |
Second Address | Hastings, NE 68901-9160 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2005 |
Last Update Date | 29/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10026498300 | (05) | NE |
10026498303 | (05) | NE |
10026498304 | (05) | NE |
47071797500 | (05) | NE |
D09073 | (02) | NE |