| Doctor Name: | DR. LARRY RAY WELLING |
| NPI Number: | 1720183874 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 2000-308 |
| Business Practice Address: | 3451 N Butler Ave Farmington, NM - 87401 |
| Business Phone Number: | 5055661915 |
| Business Fax Number: | 5055661918 |
| Mailing Address: | 3451 N Butler Ave, FARMINGTON |
| State: | NM |
| Postal Code: | 874012357 |
| Phone Number: | 5055661915 |
| Fax Number: | 5055661918 |
| NPI Enumeration Date: | 09/13/2006 |
| NPI Last Update Date: | 12/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 2000-308 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |