Basic Information
| Provider Information | |||||||||
| NPI: | 1114389541 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WELCH | ||||||||
| FirstName: | JO'EL | ||||||||
| MiddleName: | CHERI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4864 JACKSON STREET | ||||||||
| Address2: | FAMILY MEDICINE | ||||||||
| City: | MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 71210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183307000 | ||||||||
| FaxNumber: | 3183307591 | ||||||||
| Practice Location | |||||||||
| Address1: | 859 WINTER ST | ||||||||
| Address2: | |||||||||
| City: | LUCEDALE | ||||||||
| State: | MS | ||||||||
| PostalCode: | 394526603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019473161 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2016 | ||||||||
| LastUpdateDate: | 01/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 321305 | LA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 27264 | MS | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.