Provider Demographics
NPI:1801893896
Name:WELSH, JOHN MARK JR (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARK
Last Name:WELSH
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:900 WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-7447
Mailing Address - Country:US
Mailing Address - Phone:785-823-7403
Mailing Address - Fax:785-825-8857
Practice Address - Street 1:900 WESTCHESTER DR
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7447
Practice Address - Country:US
Practice Address - Phone:785-823-7403
Practice Address - Fax:785-825-8857
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS1077-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KST43680Medicare UPIN
KS1211710001Medicare NSC
KS052556Medicare ID - Type Unspecified