Healthcare Provider Details

I. General information

NPI: 1184729386
Provider Name (Legal Business Name): TRUMAN FREDERICK WEIGAND JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 11/03/2023
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 RALSTON AVE STE 204
DEFIANCE OH
43512-5309
US

IV. Provider business mailing address

1 SEAGATE STE 800
TOLEDO OH
43604-1558
US

V. Phone/Fax

Practice location:
  • Phone: 419-783-6997
  • Fax: 419-782-6103
Mailing address:
  • Phone: 419-783-6997
  • Fax: 419-782-6103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35054480
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: