Individual
JEFFREY GRANT WEYENETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1441 W CENTRAL PARK AVE, DAVENPORT, IA 52804-1707
(563) 328-5690
(563) 328-5690
Mailing address
PO BOX 2689, DAVENPORT, IA 52809-2689
(563) 271-7300
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35123
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295477
—
IA
Enumeration date
09/06/2005
Last updated
04/21/2009
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