Provider Demographics
NPI:1568609287
Name:WEATHERFORD, ALAN DAVIS (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:DAVIS
Last Name:WEATHERFORD
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:9486 HIGHWAY 412 W
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-5713
Mailing Address - Country:US
Mailing Address - Phone:731-968-0984
Mailing Address - Fax:731-967-9764
Practice Address - Street 1:200 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-2038
Practice Address - Country:US
Practice Address - Phone:731-968-3646
Practice Address - Fax:731-968-1870
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2023-09-27
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Provider Licenses
StateLicense IDTaxonomies
TN1676363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical