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General NPI Number Information
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NPI Number | 1194763151
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Entity Type | Organization
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Legal Business Name | DONALD L WEESE, M.D., P.C.
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 844 WASHINGTON ST N NUMBER 400
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City | TWIN FALLS
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State | ID
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Zip | 83301-3874
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Country | US
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Telephone | 208-735-0007
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Fax | 208-735-0008
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Provider Business Mailing Address
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Address Line | 844 WASHINGTON ST N NUMBER 400
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City | TWIN FALLS
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State | ID
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Zip | 83301-3874
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Country | US
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Telephone | 208-735-0007
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Fax | 208-735-0008
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DONALD L WEESE
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Credential | M.D.
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Telephone | 208-735-0007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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