1982692786 NPI number — MR. MORRIS M WEISS JR. M.D.

Table of content: MR. MORRIS M WEISS JR. M.D. (NPI 1982692786)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982692786 NPI number — MR. MORRIS M WEISS JR. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEISS
Provider First Name:
MORRIS
Provider Middle Name:
M
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982692786
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 E LIBERTY ST STE 800
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40202-1428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-585-4321
Provider Business Mailing Address Fax Number:
502-566-6338

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 ABRAHAM FLEXNER WAY
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-1846
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-585-4321
Provider Business Practice Location Address Fax Number:
502-566-6338
Provider Enumeration Date:
10/06/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  12715 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 060066386 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200008520 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 060014163 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 64127152 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00081137 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1145632 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com