Individual
WILLIAM WEINACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4547 SAINT STEPHENS RD, PRICHARD, AL 36613-3563
(251) 456-1399
(251) 456-0079
Mailing address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8158
(251) 544-2188
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
LNO 6048
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011846
MEDICARE GROUP PAYEE NUMBER
AL
01
—
1063439065
NPI GROUP PAYEE NUMBER
AL
05
—
630000013
—
AL
Enumeration date
10/17/2013
Last updated
10/17/2013
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