Individual
DR. JOHN HAROLD WEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
61 SULLIVAN ST, CANTON, PA 17724-1729
(570) 673-3197
(570) 673-8297
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS00372L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007678400001
—
PA
05
—
00552727
—
NY
01
—
080176490
RR MEDICARE PIN
PA
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039829
PA MEDICARE GROUP
PA
Enumeration date
02/27/2006
Last updated
09/16/2011
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