Corey Weidman PA-C

NPI 1013912104 - Physician Assistant - 363A00000X

NPI Details
NPI 1013912104
Gender Male
Enumeration Date 06/16/2005
Last Updated 10/15/2011
Entity Type Individual
Active Over 11 years ago
Practice Location
JACKSON RIVER ORTHOPEDICS
1 ARH LANE, STE 102
LOW MOOR VA, 24457, US
Phone (540) 862-6777
Fax (540) 863-9167
Business Location
PO BOX 457
5 E ALVON ROAD, SUITE 7
WHITE SULPHUR SPRINGS WV, 24986-2373, US
Phone (304) 536-5030
Fax (304) 536-5051
Toxanomy
Taxonomy Code 363A00000X
License State Virginia
License Number 0110840643
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According to our database, Corey Weidman PA-C NPI is 1013912104, taxonomy code is 363A00000X and license number is 0110840643, license state is located at Virginia. Corey Weidman PA-C physically located at Jackson River Orthopedics, Low Moor VA, 24457. NPI Number Corey Weidman PA-C has the Individual type.

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1013912104 NPI number is provided on an as is basis without warranty of any kind. 1013912104 is maintained by the National Plan & Provider Enumeration System. The contents of Corey Weidman PA-C are for informational purposes only.