Provider Demographics
NPI:1649248188
Name:WELKER, WILLIAM GERARD JR (MS, PA-C)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GERARD
Last Name:WELKER
Suffix:JR
Gender:M
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9888 W BELLEVIEW AVE # 5114
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80123-2101
Mailing Address - Country:US
Mailing Address - Phone:844-466-6829
Mailing Address - Fax:
Practice Address - Street 1:4620 REDSTONE RIDGE RD
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-8265
Practice Address - Country:US
Practice Address - Phone:561-818-8031
Practice Address - Fax:719-481-9192
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA3011363A00000X
COPA2919363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL290648100Medicaid
FL290648100Medicaid
FLE0792BMedicare PIN
FLE0792SMedicare PIN