Healthcare Provider Details

I. General information

NPI: 1295936243
Provider Name (Legal Business Name): JAMES MATHEW WEEKLY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 10/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S LLOYD ST SUITE E106
ABERDEEN SD
57401-4552
US

IV. Provider business mailing address

201 S LLOYD ST SUITE E106
ABERDEEN SD
57401-4552
US

V. Phone/Fax

Practice location:
  • Phone: 605-225-1420
  • Fax: 605-225-3307
Mailing address:
  • Phone: 605-225-1420
  • Fax: 605-225-3307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number0371
License Number StateSD

VIII. Authorized Official

Name: DR. JAMES MATHEW WEEKLY
Title or Position: OWNER
Credential: M.D.
Phone: 605-225-1420