Individual
DR. KENT L WELLISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2110 E FLAMINGO RD, #210, LAS VEGAS, NV 89119-5190
(702) 733-2020
(702) 794-2797
Mailing address
2110 E FLAMINGO RD, #210, LAS VEGAS, NV 89119-5190
(702) 733-2020
(702) 794-2797
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
21433
AZ
207W00000X
Ophthalmology Physician
Primary
7032
NV
207W00000X
Ophthalmology Physician
G74385
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002019599
—
NV
01
—
180023250
RAILROAD MEDICARE
NV
Enumeration date
05/28/2006
Last updated
12/17/2008
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