Individual
DR. JOHN A WEIDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3636 STOCKTON HILL RD, SUITE 2, KINGMAN, AZ 86409-0514
(928) 692-9555
(928) 692-2522
Mailing address
PO BOX 4552, KINGMAN, AZ 86402-4452
(928) 692-9555
(928) 692-2522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4035
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
869042
—
AZ
Enumeration date
12/15/2005
Last updated
04/02/2019
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