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General NPI Number Information
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NPI Number | 1760693071
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Entity Type | Organization
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Legal Business Name | NANCY E WEIBLE
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 6120 U S HIGHWAY 49
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City | HATTIESBURG
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State | MS
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Zip | 39401-7300
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Country | US
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Telephone | 601-288-8004
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Fax | 601-288-8012
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Provider Business Mailing Address
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Address Line | 6120 U S HIGHWAY 49
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City | HATTIESBURG
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State | MS
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Zip | 39401-7300
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Country | US
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Telephone | 601-288-8004
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Fax | 601-288-8012
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Authorized Official
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Title or Position | OWNER
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Name | NANCY ELAINE WEIBLE
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Credential | MD
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Telephone | 601-288-8004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 12913
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License Number State | MS
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