Provider Demographics
NPI:1790102671
Name:WEIR, JOSHUA SAMUEL (DO, MBA, MS)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:SAMUEL
Last Name:WEIR
Suffix:
Gender:M
Credentials:DO, MBA, MS
Other - Prefix:
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Mailing Address - Street 1:551 N HILLSIDE ST STE 320
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4926
Mailing Address - Country:US
Mailing Address - Phone:316-685-1367
Mailing Address - Fax:
Practice Address - Street 1:2077 N WEBB RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3411
Practice Address - Country:US
Practice Address - Phone:316-685-1367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-451082085R0001X
OK3902000002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology