Provider Demographics
NPI:1083678650
Name:WELSH, AUSTIN THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:THOMAS
Last Name:WELSH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3902 E GRANT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2558
Mailing Address - Country:US
Mailing Address - Phone:520-468-4801
Mailing Address - Fax:415-252-7176
Practice Address - Street 1:3902 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2558
Practice Address - Country:US
Practice Address - Phone:520-478-4801
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-32664207Q00000X
KSMD 12748207QG0300X
AZ64053207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
42128016OtherBCBS OF KANSAS
41-41155OtherEVERCARE
1588844989OtherBCBS OF KANSAS
41-41155OtherEVERCARE
1588844989OtherBCBS OF KANSAS
KA1008001Medicare PIN