Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 48071 | KY |
N | 111NI0900X | Internist | 48071 | KY |
N | 207RA0401X | Internist - Addiction Medicine | 48071 | KY |
NPI | 1255690749 |
---|---|
Provider Name | Dr. Daniel Timothy Weaver |
First Address | Lexington, KY 40536-0298 |
Second Address | Lexington, KY 40536-0298 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2012 |
Last Update Date | 07/12/2018 |