Provider Demographics
NPI:1417762733
Name:WELCH, ERIC PAUL
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:PAUL
Last Name:WELCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8405 E 146TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-3929
Mailing Address - Country:US
Mailing Address - Phone:918-640-2167
Mailing Address - Fax:
Practice Address - Street 1:8405 E 146TH ST S
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-3929
Practice Address - Country:US
Practice Address - Phone:918-640-2167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist