GERALD E WEAVER MD PC
Managed Care Organizations at Charles Ave, Worland, WY

License number
Wyoming 5731A
Category
Managed Care Organizations
Type
Exclusive Provider Organization
Owner
Name: DR. GERALD E WEAVER MD
Title: OWNER
Phone: (307) 347-2405
Address
Address
1511 Charles Ave, Worland, WY 82401
National Provider ID: 1710214036
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Gerald E. Weaver, M.D., PC

1511 Charles Ave, Worland, WY 82401

Status:
Inactive
Registration:
Dec 29, 2004
Inactive since:
Feb 8, 2015
State ID:
2004-000479936
Business type:
Profit Corporation - Domestic
Expiration:
Perpetual

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