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General NPI Number Information
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NPI Number | 1467161604
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Entity Type | Individual
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Provider Name | CAROL JORDAN WEILAND PD
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Gender | Female
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Dates
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Enumeration Date | 11/16/2022
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 533 PORTER ST
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City | HELENA
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State | AR
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Zip | 72342-3217
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Country | US
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Telephone | 870-338-3414
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Fax | 870-338-3415
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Provider Business Mailing Address
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Address Line | 1627 HIGHWAY 61 JONESTOWN RD
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City | COAHOMA
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State | MS
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Zip | 38617-9790
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Country | US
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Telephone | 662-358-7797
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 07937
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License Number State | AR
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