Individual
DR. KENNETH A WEINBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
826 MOUNT MORIAH RD, MEMPHIS, TN 38117-5705
(901) 683-3232
Mailing address
826 MOUNT MORIAH RD, MEMPHIS, TN 38117-5705
(901) 683-3232
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
749
TN
152WC0802X
Corneal and Contact Management Optometrist
Primary
749
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I411068
PTAN
TN
Enumeration date
07/05/2005
Last updated
10/22/2014
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