Organization
MARK A WEIGHT MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A WEIGHT MD (PRESIDENT)
(208) 523-0303
Entity
Organization
Contact information
Practice address
2355 CORONADO ST, IDAHO FALLS, ID 83404-7407
(208) 523-0303
Mailing address
PO BOX 1432, IDAHO FALLS, ID 83403-1432
(208) 552-8770
(208) 523-2025
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807218100
—
ID
Enumeration date
10/20/2006
Last updated
06/17/2019
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