=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235177643
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JON WELSH M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2006
-----------------------------------------------------
Last Update Date | 01/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 STATE HOSPITAL DR
-----------------------------------------------------
City | OSAWATOMIE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66064-1813
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-755-7000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6675 HOLMES RD SUITE 450
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64131-1150
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-276-7600
-----------------------------------------------------
Fax | 816-276-7090
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 04-35754
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------