Provider Demographics
NPI:1972629491
Name:WEIGEL, PAUL C (RPH)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:C
Last Name:WEIGEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SHELDON ST
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-3322
Mailing Address - Country:US
Mailing Address - Phone:641-782-8417
Mailing Address - Fax:641-782-6858
Practice Address - Street 1:600 SHELDON ST
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-3322
Practice Address - Country:US
Practice Address - Phone:641-782-8417
Practice Address - Fax:641-782-6858
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA15778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist