Provider Demographics
NPI:1053670729
Name:WEIGANDT, JULIE L (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:L
Last Name:WEIGANDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 HIGHLAND WAY
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-6426
Mailing Address - Country:US
Mailing Address - Phone:605-996-0400
Mailing Address - Fax:
Practice Address - Street 1:2100 HIGHLAND WAY
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-6426
Practice Address - Country:US
Practice Address - Phone:605-996-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10035207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology