Provider Demographics
NPI:1134238074
Name:WEYAND, JAMES JOSEPH (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:WEYAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:66 W HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-6709
Mailing Address - Country:US
Mailing Address - Phone:570-594-5028
Mailing Address - Fax:570-387-0832
Practice Address - Street 1:66 W HILLCREST DR
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-6709
Practice Address - Country:US
Practice Address - Phone:570-594-5028
Practice Address - Fax:570-387-0832
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG000309152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation