Gerald E Weaver MD PC
Organization Active NPI Exclusive Provider Organization · Worland, WY
NPI 1710214036 · NPPES record last updated Nov 6, 2009
Key facts
- NPI
- 1710214036
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Exclusive Provider Organization 302F00000X
- License
- 5731A (WY)
- Legal business name
- GERALD E WEAVER MD PC
- Practice address
- 1511 Charles Ave
Worland, WY 82401-4122 - Phone
- (307) 347-2405
- Fax
- (307) 347-3166
- NPI assigned
- Nov 6, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Gerald E Weaver, MD
- Title
- Owner
- Phone
- (307) 347-2405
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Exclusive Provider Organization | 302F00000X | 5731A | WY | Yes |
Addresses
Primary practice location
1511 Charles Ave
Worland, WY 82401-4122
Mailing address
1511 Charles Ave
Worland, WY 82401-4122
Phone (307) 347-2405
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114723400 | Medicaid | WY |
Other names
- Worland Surgery Clinic
Other providers in Worland, WY
- Brandon Galovich
- Megan Galovich
- Melissa Gardner
- Roberta D Gentile
- George G. Richardson MD PC
- Lonnie G Gerharter
- James A Gilman
- Tanner James Gooden
- Grant Hospitalists Services, LLC
- Brock Richard Greek
All providers in Worland, WY · Exclusive Provider Organization in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.