Individual
DR. LARRY RAY WELLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3451 N BUTLER AVE, FARMINGTON, NM 87401
(505) 566-1915
(505) 566-1918
Mailing address
3451 N BUTLER AVE, FARMINGTON, NM 87401-2357
(505) 566-1915
(505) 566-1918
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2000-308
NM
2083X0100X
Occupational Medicine Physician
Primary
2000-308
NM
208D00000X
General Practice Physician
2000-308
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A2516
—
NM
Enumeration date
09/13/2006
Last updated
10/15/2018
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