# MARK WEIS, MD, PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093840654
- **Authorized official:** MARK S. WEIS MD (OWNER)
- **Authorized official phone:** (859) 280-3960

## Contact information

- **Practice address:** 100 TRADE ST, STE C, LEXINGTON, KY 40511-2610
- **Practice address phone:** (859) 280-3960
- **Practice address fax:** (859) 231-1186
- **Mailing address:** 1676 ATOMA DR, LEXINGTON, KY 40511
- **Mailing address phone:** (859) 280-3960
- **Mailing address fax:** (859) 231-1186

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/23/2007
- **Last updated:** 08/22/2020