Wellborn, Keri Jo
Wellborn, Keri Jo is an individual health care provider with primary practice located at 1001 Us Highway 83 N , Childress TX 79201-2322. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wellborn, Keri Jo can be contacted via phone (940) 937-3636.Contact Information
Primary practice address
1001 Us Highway 83 N
Childress TX 79201-2322
Phone: (940) 937-3636
Fax: (940) 937-9615
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | Q7030 | Texas |
Profile Details
| NPI number | 1972915775 |
|---|---|
| LBN Legal business name | Wellborn, Keri Jo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 28th, 2014 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972915775 | NPPES |
| Texas | MEDICAID | 355764703 | |
| Texas | Other | Q7030 |
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