Individual
DR. BENJAMIN WATSON WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1819 N GREENWICH RD, SUITE B, WICHITA, KS 67206-3411
(316) 269-3338
(316) 264-5516
Mailing address
2081 N WEBB RD, WICHITA, KS 67206-3411
(316) 269-3338
(316) 264-5516
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1200336
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100454970A
—
KS
01
—
102715
BC/BS
KS
Enumeration date
10/04/2005
Last updated
04/29/2022
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