Healthcare Provider Details

I. General information

NPI: 1962084566
Provider Name (Legal Business Name): ANDREW MARTIN WELCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 STANTON L YOUNG BLVD STE 8336
OKLAHOMA CITY OK
73104-5018
US

IV. Provider business mailing address

800 STANTON L YOUNG BLVD STE 8336
OKLAHOMA CITY OK
73104-5018
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-2220
  • Fax: 405-271-5644
Mailing address:
  • Phone: 405-271-2220
  • Fax: 405-271-5644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number47999
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: