Individual
DR. KEVIN JAMES WEIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
2325 BROOKSTONE CENTRE PKWY, COLUMBUS, GA 31904-4500
(706) 653-6841
(706) 653-7843
Mailing address
2325 BROOKSTONE CENTRE PKWY, COLUMBUS, GA 31904-4500
(706) 653-6841
(706) 653-7843
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY003142
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54641
BLUECROSSBLUESHIELD
FL
01
—
7761336
AETNA PROVIDER NUMBER
FL
Enumeration date
07/14/2006
Last updated
01/12/2010
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