Provider Demographics
NPI:1235425299
Name:WEISMAN, ERRIN (DO)
Entity Type:Individual
Prefix:
First Name:ERRIN
Middle Name:
Last Name:WEISMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ERRIN
Other - Middle Name:
Other - Last Name:MORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:480 EVERSMAN DR
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-3548
Mailing Address - Country:US
Mailing Address - Phone:812-482-3020
Mailing Address - Fax:812-481-9008
Practice Address - Street 1:480 EVERSMAN DR
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3548
Practice Address - Country:US
Practice Address - Phone:812-482-3020
Practice Address - Fax:812-481-9008
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02004107A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine