Individual
DR. GORDON REESE WEIGLE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
880 W MOULTRIE ST STE 200, WINNSBORO, SC 29180-2411
(803) 635-6461
(803) 635-4200
Mailing address
PO BOX 1218, WINNSBORO, SC 29180-5218
(803) 635-6461
(803) 635-4200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
SC8901
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089013
—
SC
Enumeration date
05/17/2006
Last updated
08/23/2022
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