Provider Demographics
NPI:1972638492
Name:JOHN REED WELCH, MD, PC
Entity Type:Organization
Organization Name:JOHN REED WELCH, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:REED
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-352-6688
Mailing Address - Street 1:1616 15TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-4571
Mailing Address - Country:US
Mailing Address - Phone:970-352-6688
Mailing Address - Fax:970-353-2892
Practice Address - Street 1:1616 15TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-4571
Practice Address - Country:US
Practice Address - Phone:970-352-6688
Practice Address - Fax:970-353-2892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18065207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO23950587Medicaid
CO23950587Medicaid
CO446948Medicare ID - Type Unspecified