Provider Demographics
NPI:1669545307
Name:DR GERALD B WEINKAM INC
Entity type:Organization
Organization Name:DR GERALD B WEINKAM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:WEINKAM
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:513-791-5753
Mailing Address - Street 1:8041 HOSBROOK ROAD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236
Mailing Address - Country:US
Mailing Address - Phone:513-791-5753
Mailing Address - Fax:513-791-2435
Practice Address - Street 1:8041 HOSBROOK ROAD
Practice Address - Street 2:SUITE 107
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236
Practice Address - Country:US
Practice Address - Phone:513-791-5753
Practice Address - Fax:513-791-2435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH36001517213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0158163Medicaid
480030380AOtherRAILROAD MEDICARE
0014171Medicare PIN
T80345Medicare UPIN
OH0158163Medicaid