Individual
DR. JEREMY L WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
775 POLE LINE RD W STE 301, TWIN FALLS, ID 83301-5823
(208) 814-8700
(208) 933-4914
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
036166255
IL
208800000X
Urology Physician
45925
CO
208800000X
Urology Physician
Primary
8061375
ID
Other
Enumeration date
05/29/2007
Last updated
10/22/2024
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