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General NPI Number Information
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NPI Number | 1083892830
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Entity Type | Organization
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Legal Business Name | DR. LAURENCE E WELKER, APMC
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Dates
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Enumeration Date | 02/04/2008
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Last Update Date | 01/30/2009
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Provider Practice Location Address
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Address Line | 915 OLIVE ST
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City | SHREVEPORT
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State | LA
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Zip | 71104-2103
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Country | US
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Telephone | 318-227-0810
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Fax | 318-227-8323
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Provider Business Mailing Address
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Address Line | 915 OLIVE ST
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City | SHREVEPORT
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State | LA
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Zip | 71104-2103
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Country | US
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Telephone | 318-227-0810
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Fax | 318-227-8323
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAURENCE EDWARD WELKER
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Credential | DPM
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Telephone | 318-227-0810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | PD129R
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License Number State | LA
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