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General NPI Number Information
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NPI Number | 1124247853
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Entity Type | Organization
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Legal Business Name | DAVID H. WEINGOLD, M.D., P.A.
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 4334 E HIGHLAND DR
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City | JONESBORO
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State | AR
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Zip | 72401-6621
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Country | US
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Telephone | 870-802-3376
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Fax |
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Provider Business Mailing Address
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Address Line | 4334 E HIGHLAND DR
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City | JONESBORO
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State | AR
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Zip | 72401-6621
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Country | US
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Telephone | 870-802-3376
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Fax |
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Authorized Official
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Title or Position | INSURANCE REP.
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Name | MRS. SHEBA O. CUNNINGHAM
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Credential |
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Telephone | 870-802-3376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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