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General NPI Number Information
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NPI Number | 1982307203
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Entity Type | Organization
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Legal Business Name | RICHARD L WEITZEL JR MD LLC
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Dates
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Enumeration Date | 03/24/2023
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Last Update Date | 03/24/2023
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Provider Practice Location Address
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Address Line | 405 NILES CORTLAND RD SE STE 201
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City | WARREN
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State | OH
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Zip | 44484-2460
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Country | US
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Telephone | 330-372-2121
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Fax | 330-372-2120
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Provider Business Mailing Address
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Address Line | 405 NILES CORTLAND RD SE STE 201
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City | WARREN
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State | OH
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Zip | 44484-2460
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Country | US
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Telephone | 330-372-2121
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Fax | 330-372-2120
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Authorized Official
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Title or Position | SOLE MBR
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Name | RICHARD L WEITZEL
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Credential | MD
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Telephone | 330-727-9490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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