Provider Demographics
NPI:1255488524
Name:WELAGE, THOMAS EDWARD (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:EDWARD
Last Name:WELAGE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47240-1328
Mailing Address - Country:US
Mailing Address - Phone:812-663-8405
Mailing Address - Fax:812-663-9764
Practice Address - Street 1:946 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-2305
Practice Address - Country:US
Practice Address - Phone:812-663-8405
Practice Address - Fax:812-663-9764
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002769152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200062520Medicaid
INU58162Medicare UPIN