MEDICARE: SARAH B WEITZUL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ND0101X	MOHS-Micrographic Surgery Physician	K6515	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538138029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH B WEITZUL MD

Provider Business Mailing Address
First Line	:	4851 S I 35 E
Second Line	:	SUITE 101
City	:	CORINTH
State	:	TX
Zip	:	76210-2348
Country	:	US
Telephone Number	:	940-591-0900
Fax Number	:

Provider Business Practice Location Address
First Line	:	4851 S I 35 E
Second Line	:	SUITE 101
City	:	CORINTH
State	:	TX
Zip	:	76210-2348
Country	:	US
Telephone Number	:	940-591-0900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	09/07/2016

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Directions to “ SARAH B WEITZUL MD” Practice Location

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