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Individual

IAN LANDON WEISBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
550 REDSTONE AVE W STE 430, CRESTVIEW, FL 32536-6457
(850) 854-3278
(850) 616-9164
Mailing address
550 REDSTONE AVE W STE 430, CRESTVIEW, FL 32536-6457
(850) 854-3278
(850) 616-9164

Taxonomy

Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
MD32189
AL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
ME108041
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1134297385
AL
05
2678300
FL
Enumeration date
12/04/2006
Last updated
03/28/2025
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