Provider Demographics
NPI:1023015179
Name:WELSH, JAMES WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAM
Last Name:WELSH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 4TH ST. S.
Mailing Address - Street 2:PO BOX 194
Mailing Address - City:NORTHWOOD
Mailing Address - State:IA
Mailing Address - Zip Code:50459-0194
Mailing Address - Country:US
Mailing Address - Phone:641-324-1626
Mailing Address - Fax:
Practice Address - Street 1:104 4TH ST. S.
Practice Address - Street 2:
Practice Address - City:NORTHWOOD
Practice Address - State:IA
Practice Address - Zip Code:50459-0194
Practice Address - Country:US
Practice Address - Phone:641-324-1626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2013-10-14
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-12-05
Provider Licenses
StateLicense IDTaxonomies
IA05065111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN71351WEOtherBC/BS MN NUMBER
IA0222059Medicaid
22205Medicare UPIN