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General NPI Number Information
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NPI Number | 1811941107
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Entity Type | Individual
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Provider Name | JAN J. WEISBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 5 PHYSICIANS PARK SUITE 4
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City | FRANKFORT
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State | KY
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Zip | 40601-4163
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Country | US
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Telephone | 502-227-9911
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Fax | 502-226-6455
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Provider Business Mailing Address
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Address Line | 5 PHYSICIANS PARK SUITE 4
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City | FRANKFORT
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State | KY
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Zip | 40601-4163
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Country | US
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Telephone | 502-227-9911
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Fax | 502-226-6455
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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 | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 26843
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License Number State | KY
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