MEDICARE: DR. ANITA LYNN WEISBERGER 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	207V00000X	Obstetrics & Gynecology Physician	35-082722	OH
2	207V00000X	Obstetrics & Gynecology Physician	38229	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P01933970	OTHER	OH	RAILROAD MEDICARE

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922077593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANITA LYNN WEISBERGER MD

Provider Business Mailing Address
First Line	:	1955 DIXIE HWY STE C
Second Line	:
City	:	FT WRIGHT
State	:	KY
Zip	:	41011-2882
Country	:	US
Telephone Number	:	859-292-9215
Fax Number	:	859-292-9220

Provider Business Practice Location Address
First Line	:	1955 DIXIE HWY
Second Line	:	STE C
City	:	FT WRIGHT
State	:	KY
Zip	:	41011-2792
Country	:	US
Telephone Number	:	859-341-5550
Fax Number	:	859-344-3782

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

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	11/02/2020

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