Individual
LAWRENCE D WEIDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1900 HARRISON AVE, PANAMA CITY, FL 32405-4542
(850) 769-7546
(850) 785-2123
Mailing address
1900 HARRISON AVE, PANAMA CITY, FL 32405-4542
(850) 769-7546
(850) 785-2123
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA217838
OR
363AM0700X
Medical Physician Assistant
Primary
9105951
FL
363AM0700X
Medical Physician Assistant
PA217838
OR
363AM0700X
Medical Physician Assistant
PA2893
AL
Other
Enumeration date
04/28/2006
Last updated
08/11/2026
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