Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 10602 | AZ |
N | 207Q00000X | Family Doctor | 4914 | AK |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 10602 | AZ |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 4914 | AK |
NPI | 1184734410 |
---|---|
Provider Name | Barry D Weiss |
First Address | Tucson, AZ 85756-7124 |
Second Address | Tucson, AZ 85724-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 02/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
210310 | (05) | AZ |
380000449 | RAILROAD MEDICARE (01) | AZ |
D37818 | (02) | |
MD48591 | (05) | AK |