Provider Demographics
NPI:1497856223
Name:GARY B WEINER MD CHARTERED
Entity Type:Organization
Organization Name:GARY B WEINER MD CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:B
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-825-7271
Mailing Address - Street 1:1410 E IRON AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3285
Mailing Address - Country:US
Mailing Address - Phone:785-825-7271
Mailing Address - Fax:785-825-0957
Practice Address - Street 1:1410 E IRON AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3285
Practice Address - Country:US
Practice Address - Phone:785-825-7271
Practice Address - Fax:785-825-0957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0000016672OtherBCBS OF KS
KS0000016672Medicare UPIN