Individual
DR. JONATHAN RANDOLPH WEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12700 SOUTHFORK RD STE 260, SAINT LOUIS, MO 63128-3288
(314) 543-5270
Mailing address
12700 SOUTHFORK RD STE 260, SAINT LOUIS, MO 63128-3288
(314) 543-5270
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2021016379
MO
Other
Enumeration date
06/21/2016
Last updated
06/30/2021
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