Provider Demographics
NPI:1811198310
Name:RICHARD H. WEYER MD PC
Entity Type:Organization
Organization Name:RICHARD H. WEYER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:HELGE
Authorized Official - Last Name:WEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-458-1787
Mailing Address - Street 1:165 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2807
Mailing Address - Country:US
Mailing Address - Phone:520-458-1787
Mailing Address - Fax:520-458-1519
Practice Address - Street 1:165 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2807
Practice Address - Country:US
Practice Address - Phone:520-458-1787
Practice Address - Fax:520-458-1519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11286207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0019120OtherBLUE CROSS
AZ4127705OtherAETNA
AZE38622OtherSTERLING
AZ00022006400OtherDES
AZ121974OtherHEALTHNET
AZAZ0019120OtherBLUE CROSS
AZ00022006400OtherDES
AZ=========OtherARIZONA FOUDATION
AZ121974OtherHEALTHNET
AZ=========OtherUNITED HEALTHCARE