MEDICARE: DR. KEVIN D WEIKART M.D.

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	207R00000X	Internal Medicine Physician	MOMDR5G33	MO

General Provider Information

NPI Number	:	1902864986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN D WEIKART M.D.

Provider Business Mailing Address
First Line	:	1002 PERUQUE CROSSING CT STE 101
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63366-2381
Country	:	US
Telephone Number	:	636-887-0812
Fax Number	:	636-237-7877

Provider Business Practice Location Address
First Line	:	1002 PERUQUE CROSSING CT
Second Line	:	SUITE 101
City	:	O FALLON
State	:	MO
Zip	:	63366-2362
Country	:	US
Telephone Number	:	636-294-5900
Fax Number	:	636-294-5908

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	09/09/2025

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