Provider Demographics
NPI:1376697128
Name:WELCH AND ALLAN, MD PA
Entity Type:Organization
Organization Name:WELCH AND ALLAN, MD PA
Other - Org Name:DR'S WELCH, ALLAN, & HATCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-733-2400
Mailing Address - Street 1:526 SHOUP AVE W STE H
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-5050
Mailing Address - Country:US
Mailing Address - Phone:208-733-2400
Mailing Address - Fax:208-734-0343
Practice Address - Street 1:526 SHOUP AVE W STE H
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-5050
Practice Address - Country:US
Practice Address - Phone:208-733-2400
Practice Address - Fax:208-734-0343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1104280001Medicare NSC
ID1375900Medicare ID - Type Unspecified