Provider Demographics
NPI:1235177643
Name:WELSH, JON (MD)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:WELSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6675 HOLMES RD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1150
Mailing Address - Country:US
Mailing Address - Phone:816-276-7600
Mailing Address - Fax:816-276-7090
Practice Address - Street 1:6675 HOLMES RD
Practice Address - Street 2:SUITE 360
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1150
Practice Address - Country:US
Practice Address - Phone:816-276-7600
Practice Address - Fax:816-276-7992
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR8P41207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100399030CMedicaid
MO207787524Medicaid
MOF36112Medicare UPIN
MOP00112755Medicare PIN
KS100399030CMedicaid