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General NPI Number Information
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NPI Number | 1215960471
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Entity Type | Individual
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Provider Name | TIFFANY N WEATHERS MD
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Gender | Female
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 4301 GREATHOUSE SPRINGS ROAD WILLOW CREEK HOSPITAL
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City | JOHNSON
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State | AR
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Zip | 72741
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Country | US
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Telephone | 479-684-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 5204 W VILLAGE PKWY STE 11
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City | ROGERS
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State | AR
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Zip | 72758-8146
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Country | US
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Telephone | 479-790-4905
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | E-4745
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License Number State | AR
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