Healthcare Provider Details

I. General information

NPI: 1134333859
Provider Name (Legal Business Name): PHILLIP WEEMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 04/20/2023
Certification Date: 04/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL STAFF SERVICES/ LYNCHBURG GENERAL HOSPITAL 1901 TATE SPRINGS ROAD
LYNCHBURG VA
24501
US

IV. Provider business mailing address

1820 RICE MINE RD N SUITE 200
TUSCALOOSA AL
35406-3281
US

V. Phone/Fax

Practice location:
  • Phone: 540-587-2178
  • Fax: 434-485-0550
Mailing address:
  • Phone: 205-759-6925
  • Fax: 205-759-6926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberMD041489
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberMD.28617
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101278395
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: