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Individual

DR. KENNETH A WEINBERG

Active
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Individual

DR. KENNETH A WEINBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
749
TN
152WC0802X
Corneal and Contact Management Optometrist
Primary
749
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I411068
PTAN
TN
Enumeration date
07/05/2005
Last updated
10/22/2014
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