Provider Demographics
NPI:1376981894
Name:WELCH, ROBERT JOEL (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOEL
Last Name:WELCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:R
Other - Middle Name:JOEL
Other - Last Name:WELCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1055 N 300 W STE 500
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3312
Mailing Address - Country:US
Mailing Address - Phone:801-357-7704
Mailing Address - Fax:801-357-7424
Practice Address - Street 1:1055 N 300 W STE 500
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3312
Practice Address - Country:US
Practice Address - Phone:801-357-7704
Practice Address - Fax:801-357-7424
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT141907241205207WX0107X
WA61037925207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Multi-Specialty