# GORDON R. WEIGLE, MD PA

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

## Provider details

- **NPI number:** 1174795900
- **Authorized official:** DR. GORDON REESE WEIGLE II M.D. (OWNER)
- **Authorized official phone:** (803) 533-0091

## Contact information

- **Practice address:** 1717 VILLAGE PARK DR, ORANGEBURG, SC 29118-2475
- **Practice address phone:** (803) 533-0091
- **Practice address fax:** (803) 533-6084
- **Mailing address:** 1717 VILLAGE PARK DR, ORANGEBURG, SC 29118-2475
- **Mailing address phone:** (803) 533-0091
- **Mailing address fax:** (803) 533-6084

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | SC8901 | SC | Yes |

## Other

- **Enumeration date:** 04/01/2008
- **Last updated:** 04/02/2008