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General NPI Number Information
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NPI Number | 1366631285
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Entity Type | Organization
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Legal Business Name | CHARLES G WELCH, P.C.
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 12/22/2010
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Provider Practice Location Address
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Address Line | 1613 STAMPEDE AVE SUITE A
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City | CODY
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State | WY
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Zip | 82414-4710
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Country | US
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Telephone | 307-587-9800
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Fax | 307-587-9830
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Provider Business Mailing Address
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Address Line | PO BOX 1330
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City | POWELL
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State | WY
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Zip | 82435-1330
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Country | US
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Telephone | 307-754-3319
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Fax | 307-754-2443
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES G WELCH
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Credential | MD
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Telephone | 307-587-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 6582A
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License Number State | WY
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