Individual
DR. GARY LANE WEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 S. ARKANSAS STREET, LEESVILLE, LA 71446
(337) 239-7227
(337) 238-4922
Mailing address
1020 W FERTITTA BLVD, LEESVILLE, LA 71446-4645
(337) 419-0735
(337) 238-5089
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
339940
LA
208600000X
Surgery Physician
339940
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2649345
—
LA
05
—
3434512
—
LA
Enumeration date
02/12/2007
Last updated
08/22/2024
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