Provider Demographics
NPI:1265410393
Name:WEYMAN, CHRISTINE (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:WEYMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BOURNE AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-1916
Mailing Address - Country:US
Mailing Address - Phone:606-678-4761
Mailing Address - Fax:606-676-9671
Practice Address - Street 1:45 ROBERTS ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1295
Practice Address - Country:US
Practice Address - Phone:606-679-4416
Practice Address - Fax:606-679-4419
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY284282083P0901X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY20001012Medicaid
KY20023016Medicaid
KY20100012Medicaid
KY600000712OtherRR MEDICARE ADAIR
KY600000716OtherRR MEDICARE GREEN
KY20044012Medicaid
KY20074019Medicaid
KY600000714OtherRR MEDICARE CLINTON
KY20104014Medicaid
KY600000718OtherRR MEDICARE PULASKI
KY20027017Medicaid
KY20029013Medicaid
KY600000722OtherRR MEDICARE WAYNE
KY20901211Medicaid
KY600000717OtherRR MEDICARE MCCREARY
KY600000719OtherRR MEDICARE RUSSELL
KY600000720OtherRR MEDICARE TAYLOR
KY600000713OtherRR MEDICARE CASEY
KY600000715OtherRR MEDICARE CUMBERLAND
KY600000715OtherRR MEDICARE CUMBERLAND
KY600000719OtherRR MEDICARE RUSSELL
KY20901211Medicaid
KY20100012Medicaid
KY20023016Medicaid
KY300802Medicare PIN
KY300702Medicare PIN
KY600000718OtherRR MEDICARE PULASKI
KY300502Medicare PIN
KY300202Medicare PIN
KY300302Medicare PIN