Individual
JEFFREY S WEATHERALL
Active
Individual
JEFFREY S WEATHERALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
34933
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010258693
—
VA
05
—
3868408
—
TN
01
—
4119268
BCBST
—
05
—
64032592
—
KY
01
—
P00303258
RAILROAD MEDICARE
—
Enumeration date
05/31/2006
Last updated
04/12/2017
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