Healthcare Provider Details

I. General information

NPI: 1366972135
Provider Name (Legal Business Name): JAMIE DREW WEINAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MEGAN ROSE WEINAND

II. Dates (important events)

Enumeration Date: 06/14/2017
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3655 E GRANT RD
TUCSON AZ
85716-2933
US

IV. Provider business mailing address

839 W CONGRESS ST
TUCSON AZ
85745-2819
US

V. Phone/Fax

Practice location:
  • Phone: 520-670-3909
  • Fax: 520-309-2560
Mailing address:
  • Phone: 520-670-3909
  • Fax: 520-309-2560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberMD2019-0662
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number59481
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: