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NPI Code Detail

MEDICARE: JACQUELIN A WEIL MD

MEDICARE: JACQUELIN A WEIL 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
1207Q00000XFamily Medicine PhysicianJ8780TX
2207Q00000XFamily Medicine Physician12075NV

General Provider Information

NPI Number : 1912971847
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELIN A WEIL MD
Provider Business Mailing Address
First Line : 653 TOWN CENTER DR #514
Second Line :
City : LAS VEGAS
State : NV
Zip : 89144-0519
Country : US
Telephone Number : 702-243-2689
Fax Number : 702-243-2632
Provider Business Practice Location Address
First Line : 653 TOWN CENTER DR
Second Line : #514
City : LAS VEGAS
State : NV
Zip : 89144-0519
Country : US
Telephone Number : 702-243-2689
Fax Number : 702-243-2632
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 01/09/2008

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Directions to “ JACQUELIN A WEIL MD” Practice Location

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