Provider Demographics
NPI:1386424109
Name:WELFORD, ALEXANDER (PA-C)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:WELFORD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 PARK AVENUE
Mailing Address - Street 2:MASTERS OF PHYSICIAN STUDIES
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06822
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5151 PARK AVENUE
Practice Address - Street 2:MASTERS OF PHYSICIAN STUDIES
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06822
Practice Address - Country:US
Practice Address - Phone:203-371-7999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT6430363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program