MEDICARE: GARY B WEINER MD

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	207W00000X	Ophthalmology Physician	0423696	KS

General Provider Information

NPI Number	:	1336143213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY B WEINER MD

Provider Business Mailing Address
First Line	:	1410 E IRON AVE
Second Line	:	STE 5
City	:	SALINA
State	:	KS
Zip	:	67401-3285
Country	:	US
Telephone Number	:	785-825-7271
Fax Number	:	785-825-0957

Provider Business Practice Location Address
First Line	:	1410 E IRON AVE
Second Line	:	STE 5
City	:	SALINA
State	:	KS
Zip	:	67401-3285
Country	:	US
Telephone Number	:	785-825-7271
Fax Number	:	785-825-0957

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/08/2007

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Directions to “ GARY B WEINER MD” Practice Location

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