Provider Demographics
NPI:1184121576
Name:WEBER, ERIC ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ROBERT
Last Name:WEBER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 MEDICAL LOOP STE 4
Mailing Address - Street 2:
Mailing Address - City:WHITLEY CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42653-4382
Mailing Address - Country:US
Mailing Address - Phone:606-376-2639
Mailing Address - Fax:
Practice Address - Street 1:19 MEDICAL LOOP STE 4
Practice Address - Street 2:
Practice Address - City:WHITLEY CITY
Practice Address - State:KY
Practice Address - Zip Code:42653-4382
Practice Address - Country:US
Practice Address - Phone:606-376-2639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2021-0999207Q00000X
TXU4043207Q00000X
KYTP624207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine