Individual
DONALD L WEESE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 HILAND AVE STE H, BURLEY, ID 83318-2688
(208) 677-6266
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
33863
OK
208800000X
Urology Physician
Primary
M-6230
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200785630B
—
OK
Enumeration date
06/01/2005
Last updated
11/21/2024
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