Provider Demographics
NPI:1205855319
Name:R G WELCH NEUROLOGY CONSULTANT & ASSOC LTD
Entity Type:Organization
Organization Name:R G WELCH NEUROLOGY CONSULTANT & ASSOC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BURGER
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:618-235-3378
Mailing Address - Street 1:333 S ILLINOIS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-2153
Mailing Address - Country:US
Mailing Address - Phone:628-235-3378
Mailing Address - Fax:618-235-2620
Practice Address - Street 1:333 S ILLINOIS ST
Practice Address - Street 2:SUITE B
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-2153
Practice Address - Country:US
Practice Address - Phone:628-235-3378
Practice Address - Fax:618-235-2620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty