Provider Demographics
NPI:1508834128
Name:WEIGEL, NANCY S (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:S
Last Name:WEIGEL
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 1:333 BEACON HILL RD STE 201
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-6182
Mailing Address - Country:US
Mailing Address - Phone:606-780-0444
Mailing Address - Fax:606-784-2344
Practice Address - Street 1:333 BEACON HILL RD STE 201
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-6182
Practice Address - Country:US
Practice Address - Phone:606-780-0444
Practice Address - Fax:606-784-2344
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32172208VP0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64321722Medicaid
D15909Medicare UPIN
KY64321722Medicaid