Organization
WELDON MEDICAL PRODUCTS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYLER WAYNE WELDON C-PED (OWNER/OPERATOR)
(904) 237-5648
Entity
Organization
Contact information
Practice address
36 S COLLEGE ST, SUITE 102, MACCLENNY, FL 32063-2439
(904) 472-5374
(904) 259-0579
Mailing address
36 S COLLEGE ST, SUITE 102, MACCLENNY, FL 32063-2439
(904) 472-5374
(904) 259-0579
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
PED 228
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
224L00000X
CMS- TAXONOMY CODE FOR 'PEDORTHIST'
FL
Enumeration date
01/14/2015
Last updated
01/15/2015
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