Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 67627 | GA |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | L6212 | TX |
NPI | 1043288418 |
---|---|
Provider Name | Dr. Lloyd Damon Weddington |
First Address | Austell, GA 30106-6831 |
Second Address | Marietta, GA 30062-6227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 26/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B84664 | (02) |