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General NPI Number Information
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NPI Number | 1033832654
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Entity Type | Individual
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Provider Name | DOUGLAS R WELCH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 1645 W GOVERNMENT COVE SUITE E
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City | BRANDON
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State | MS
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Zip | 39042
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Country | US
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Telephone | 601-720-5775
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Fax | 601-825-2356
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Provider Business Mailing Address
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Address Line | 405 FAWNWOOD DR
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City | BRANDON
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State | MS
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Zip | 39042-4007
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Country | US
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Telephone | 601-668-0688
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10996
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | T-12241
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License Number State | MS
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