Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 18488 | AL |
Y | 207N00000X | Dermatologist | ME0066724 | FL |
NPI | 1013998772 |
---|---|
Provider Name | Dr. Kevin L Welch |
First Address | Pensacola, FL 32514-6050 |
Second Address | Pensacola, FL 32514-6050 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 19/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E69627 | (02) |