Individual
DR. RONALD WEINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
17 CENTRE PLAZA DR, JACKSON, TN 38305-2862
(731) 512-0104
(731) 668-7388
Mailing address
17 CENTRE PLAZA DR, JACKSON, TN 38305-2862
(731) 512-0104
(731) 668-7388
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
1124
TN
207RC0000X
Cardiovascular Disease Physician
Primary
DO1124
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060053873
RAILROAD MEDICARE
TN
01
—
1952206
CIGNA HEALTHCARE
TN
01
—
3122211
BCBS PROVIDER NUMBER
TN
05
—
3304299
—
TN
01
—
5010926
TLC PROVIDER
TN
01
—
5339059
AETNA PROVIDER NUMBER
TN
01
—
6238568
BCBST
TN
Enumeration date
05/19/2006
Last updated
01/08/2024
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