Healthcare Provider Details

I. General information

NPI: 1033180138
Provider Name (Legal Business Name): MR. JAMES S WEISENSEE
Entity Type: Individual
Gender: Male
Sole Proprietor: X

Provider Other Name: JAMES S WEISENSEE D.O.

II. Dates (important events)

Enumeration Date: 01/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 EKASTOWN RD
SARVER PA
16055-9724
US

IV. Provider business mailing address

154 DODDS RD
BUTLER PA
16002-0470
US

V. Phone/Fax

Practice location:
  • Phone: 724-353-1508
  • Fax: 724-353-2040
Mailing address:
  • Phone: 724-586-9769
  • Fax: 724-353-2040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberOS003532L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: