Provider Demographics
NPI:1669443354
Name:WEEMS, ALAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
Last Name:WEEMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1111 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE S750
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3151
Mailing Address - Country:US
Mailing Address - Phone:504-340-6976
Mailing Address - Fax:504-349-6786
Practice Address - Street 1:1051 GAUSE BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2951
Practice Address - Country:US
Practice Address - Phone:985-641-4144
Practice Address - Fax:985-201-7924
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2017-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA0531R174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAA99631Medicare UPIN