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1982307203 NPI number — RICHARD L WEITZEL JR MD LLC

NPI Number: 1982307203
Health Care Provider/Practitioner: RICHARD L WEITZEL JR MD LLC

Information about “1982307203” NPI (RICHARD L WEITZEL JR MD LLC) exists in 1982307203 in HTML format HTML  |  1982307203 in plain Text format TXT  |  1982307203 in PDF (Portable Document Format) PDF  |  1982307203 in an XML format XML  formats.

NPI Number : 1982307203 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1982307203",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "RICHARD L WEITZEL JR MD LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "405 NILES CORTLAND RD SE STE 201",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WARREN",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "44484-2460",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "330-372-2121",
    "MailingAddressFaxNumber": "330-372-2120",
    "FirstLinePracticeLocationAddress": "405 NILES CORTLAND RD SE STE 201",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WARREN",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "44484-2460",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "330-372-2121",
    "PracticeLocationAddressFaxNumber": "330-372-2120",
    "EnumerationDate": "03/24/2023",
    "LastUpdateDate": "03/24/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WEITZEL",
    "AuthorizedOfficialFirstName": "RICHARD",
    "AuthorizedOfficialMiddleName": "L",
    "AuthorizedOfficialTitle": "SOLE MBR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "330-727-9490",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QM2500X",
        "TaxonomyName": "Medical Specialty Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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