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General NPI Number Information
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NPI Number | 1134866734
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Entity Type | Individual
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Provider Name | TAYLOR WELSH OD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2022
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Last Update Date | 08/02/2022
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Provider Practice Location Address
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Address Line | 2901 S MCINTIRE DR
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City | BLOOMINGTON
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State | IN
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Zip | 47403-4209
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Country | US
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Telephone | 812-332-1401
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Fax |
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Provider Business Mailing Address
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Address Line | 1950 OLD GALLOWS RD STE 520
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City | VIENNA
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State | VA
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Zip | 22182-3970
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Country | US
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Telephone | 703-847-8899
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Fax | 571-223-6780
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18004354A
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License Number State | IN
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