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Organization

BLAKE WELLING, MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BLAKE G. WELLING M.D. (PHYSICIAN)
(801) 387-6520
Entity
Organization

Contact information

Practice address
4403 HARRISON BLVD, SUITE 1815, OGDEN, UT 84403-3271
(801) 387-6520
(801) 387-6525
Mailing address
4403 HARRISON BLVD, SUITE 1815, OGDEN, UT 84403-3271
(801) 387-6520
(801) 387-6525

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
97-344917-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
528113182005
UT
Enumeration date
02/17/2007
Last updated
02/26/2010
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