Individual
MR. BRADLEY WAYNE WELCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS, RVT, RDCS
Contact information
Practice address
720 N COMMERCE ST # 226, ARDMORE, OK 73401-3915
(580) 223-4770
(580) 223-4899
Mailing address
5294 KINGS RD, ARDMORE, OK 73401-8873
(580) 226-0583
(580) 223-4899
Taxonomy
Speciality
Code
Description
License number
State
246XS1301X
Sonography Specialist/Technologist Cardiovascular
—
—
2471V0105X
Vascular Sonography Radiologic Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
731512719001
BLUECROSS BLUESHIELD
OK
Enumeration date
09/16/2006
Last updated
09/11/2025
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