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General NPI Number Information
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NPI Number | 1366937823
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Entity Type | Individual
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Provider Name | CONNOR B WEIR DO
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Gender | Male
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 07/16/2023
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Provider Practice Location Address
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Address Line | 401 W GREENLAWN AVE
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City | LANSING
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State | MI
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Zip | 48910-2819
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Country | US
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Telephone | 517-975-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 1108 ROSS CLARK CIR
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City | DOTHAN
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State | AL
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Zip | 36301-3022
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Country | US
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Telephone | 334-793-8111
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 5101024157
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | DO.3238
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License Number State | AL
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