Provider Demographics
NPI:1649763095
Name:WEINER, LEE GARRISON (MD)
Entity type:Individual
Prefix:MR
First Name:LEE
Middle Name:GARRISON
Last Name:WEINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1410 E IRON AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3285
Mailing Address - Country:US
Mailing Address - Phone:785-825-7271
Mailing Address - Fax:785-825-0957
Practice Address - Street 1:1410 E IRON AVE STE 5
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3285
Practice Address - Country:US
Practice Address - Phone:785-825-7271
Practice Address - Fax:785-825-0957
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-46160207W00000X
KS94-09577207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine