Provider Demographics
NPI:1952317893
Name:WELCH, JASON ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:ADAM
Last Name:WELCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1712 E. BROAD STREET
Mailing Address - Street 2:JENCARE NEIGHBORHOOD MEDICAL SHOCKOE BOTTOM LLC
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223
Mailing Address - Country:US
Mailing Address - Phone:804-344-9848
Mailing Address - Fax:804-344-5644
Practice Address - Street 1:1712 E. BROAD STREET
Practice Address - Street 2:JENCARE NEIGHBORHOOD MEDICAL SHOCKOE BOTTOM LLC
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223
Practice Address - Country:US
Practice Address - Phone:804-344-9848
Practice Address - Fax:804-344-5644
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2015-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101249122207P00000X, 207Q00000X
GA058031207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine