Individual
JOEL TRACY WEIGAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
507 E 16TH ST STE 1, WELLINGTON, KS 67152-2828
(620) 326-3301
(620) 326-7086
Mailing address
507 E 16TH ST STE 1, WELLINGTON, KS 67152-2828
(620) 326-3301
(620) 326-7086
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14756
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080048662
RAILROAD MEDICARE
—
05
—
100083730A
—
KS
01
—
1437283991
GROUP NPI
—
01
—
14746
COVENTRY
—
01
—
1475
BCBS
KS
01
—
4096976
AETNA
—
01
—
993
PREFERRED PLUS OF KANSAS
KS
01
—
CS5682
RAILROAD GROUP ID
—
Enumeration date
11/04/2005
Last updated
05/08/2020
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