Provider Demographics
NPI:1568444974
Name:WELSH, THOMAS E III (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:WELSH
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2106
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39302-2106
Mailing Address - Country:US
Mailing Address - Phone:601-703-4331
Mailing Address - Fax:601-703-3080
Practice Address - Street 1:25117 HIGHWAY 15
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MS
Practice Address - Zip Code:39365-9088
Practice Address - Country:US
Practice Address - Phone:601-774-8214
Practice Address - Fax:601-774-8379
Is Sole Proprietor?:No
Enumeration Date:2005-11-20
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS15061207P00000X, 208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00117230Medicaid
MS00117230Medicaid