Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | PD129R | LA |
NPI | 1427160951 |
---|---|
Provider Name | Dr. Laurence E Welker |
First Address | Shreveport, LA 71104-2103 |
Second Address | Shreveport, LA 71104-2103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 26/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1928577 | (05) | LA |
T96925 | (02) | LA |