Provider Demographics
NPI:1134155302
Name:ZWEIG, JEFFREY LAWRENCE (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LAWRENCE
Last Name:ZWEIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JEFFREY
Other - Middle Name:LAWRENCE
Other - Last Name:ZWEIG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:803 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30642-1211
Mailing Address - Country:US
Mailing Address - Phone:706-453-1201
Mailing Address - Fax:706-454-0337
Practice Address - Street 1:803 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:GA
Practice Address - Zip Code:30642-1211
Practice Address - Country:US
Practice Address - Phone:706-453-1201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA45374207V00000X, 207V00000X
CAG28120207V00000X
OK24890207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200093320AMedicaid
GA00835073BMedicaid
GA00835073BMedicaid
GA16BDTVJMedicare ID - Type Unspecified
OK200093320AMedicaid
GAA43615Medicare UPIN