Provider Demographics
NPI:1174678510
Name:WELSH, DOLAN KENT (PHD)
Entity Type:Individual
Prefix:DR
First Name:DOLAN
Middle Name:KENT
Last Name:WELSH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 AIRPORT BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-3169
Mailing Address - Country:US
Mailing Address - Phone:251-343-2597
Mailing Address - Fax:251-342-0122
Practice Address - Street 1:5901 AIRPORT BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3169
Practice Address - Country:US
Practice Address - Phone:251-343-2597
Practice Address - Fax:251-342-0122
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL273103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL040664OtherMANAGED HEALTH NETWORK
AL173978OtherCOMPSYCH
AL51099419OtherAMERICAN BEHAVIORAL
AL31969OtherUNITED HEALTH CARE
AL51070623OtherBLUE CROSS BLUE SHIELD
AL31969OtherUNITED HEALTH CARE
AL70623Medicare ID - Type Unspecified