MEDICARE: DR. WILLIAM ELLIOT WEDDLE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	0101029423	VA

General Provider Information

NPI Number	:	1295726222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM ELLIOT WEDDLE M.D.

Provider Business Mailing Address
First Line	:	77 HEAH TON LN
Second Line	:
City	:	LEXINGTON
State	:	VA
Zip	:	24450-7427
Country	:	US
Telephone Number	:	540-261-3388
Fax Number	:

Provider Business Practice Location Address
First Line	:	1613 OAKWOOD ST
Second Line	:
City	:	BEDFORD
State	:	VA
Zip	:	24523-1213
Country	:	US
Telephone Number	:	540-586-2441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	07/22/2008

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