Provider Demographics
NPI:1609851773
Name:WEIL, ARNOLD JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:JAY
Last Name:WEIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:335 ROSELANE ST NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7902
Mailing Address - Country:US
Mailing Address - Phone:770-883-4854
Mailing Address - Fax:770-234-5526
Practice Address - Street 1:335 ROSELANE ST NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-6969
Practice Address - Country:US
Practice Address - Phone:770-420-4645
Practice Address - Fax:770-234-5526
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA360352081P2900X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF02282Medicare UPIN
GA25BDBFPMedicare ID - Type Unspecified