Provider Demographics
NPI:1659556280
Name:WEISMAN, AINSLEY VIRGINIA (PA-C)
Entity Type:Individual
Prefix:
First Name:AINSLEY
Middle Name:VIRGINIA
Last Name:WEISMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AINSLEY
Other - Middle Name:VIRGINIA
Other - Last Name:ZINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0449
Mailing Address - Country:US
Mailing Address - Phone:740-374-4500
Mailing Address - Fax:740-374-5887
Practice Address - Street 1:400 MATTHEW ST STE 401
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1656
Practice Address - Country:US
Practice Address - Phone:740-434-3505
Practice Address - Fax:740-568-4091
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50003877363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP01469270OtherRAILROAD MEDICARE MHCPI
OH0102369Medicaid
OHH266840Medicare PIN