Organization
JAMES L WEATHERHEAD MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES LEE WEATHERHEAD M.D. (OWNER)
(269) 948-7820
Entity
Organization
Contact information
Practice address
1005 W GREEN ST, SUITE G100, HASTINGS, MI 49058-1712
(269) 948-7820
(269) 948-2458
Mailing address
1005 W GREEN ST, SUITE G100, HASTINGS, MI 49058-1712
(269) 948-7820
(269) 948-2458
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0800822151
BLUE CROSS BLUE SHIELD
MI
05
—
209975510
—
MI
Enumeration date
03/11/2008
Last updated
01/20/2009
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