Provider Demographics
NPI:1073765210
Name:ROBERT WELKER MD, PC
Entity Type:Organization
Organization Name:ROBERT WELKER MD, PC
Other - Org Name:ADVANCED FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:WELKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-628-4444
Mailing Address - Street 1:195 W TELEGRAPH ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-1675
Mailing Address - Country:US
Mailing Address - Phone:435-268-4444
Mailing Address - Fax:435-268-4447
Practice Address - Street 1:195 W TELEGRAPH ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-1675
Practice Address - Country:US
Practice Address - Phone:435-268-4444
Practice Address - Fax:435-268-4447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1768961205261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service