Mark Justin Weiss
Ophthalmologist
1717 S Utica Ave Ste 107
Tulsa
, Oklahoma 74104-5317
Mark Justin Weiss
Ophthalmologist
1717 S Utica Ave Ste 107
Tulsa
, Oklahoma 74104-5317
(918) 742-8435
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About
Features
Specialties
- Ophthalmologist
Languages spoken
- English
Location
First Address
- Mark Justin Weiss
- 1717 S Utica Ave Ste 107
- Tulsa, OK
- Zip : 74104-5317
- Fax : (918) 742-8435
- Phone : (918) 742-2428
Second Address
- Mark Justin Weiss
- 1717 S Utica Ave Ste 107
- Tulsa, OK
- Zip : 74104-5317
- Fax : (918) 742-8435
- Phone : (918) 742-2428
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207W00000X | Ophthalmologist | 9126 | OK |
National Provider Identifier
| NPI | 1003801481 |
|---|---|
| Provider Name | Mark Justin Weiss |
| First Address | Tulsa, OK 74104-5317 |
| Second Address | Tulsa, OK 74104-5317 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/09/2005 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| D35392 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.