| Gordon R. Weigle, Md Pa | |
|
1717 Village Park Dr Orangeburg SC 29118-2475 | |
| (803) 533-0091 | |
| (803) 533-6084 |
| Full Name | Gordon R. Weigle, Md Pa |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 1717 Village Park Dr, Orangeburg, South Carolina |
| Authorized Official Name and Position | Gordon Reese Weigle (OWNER) |
| Authorized Official Contact | 8035330091 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gordon R. Weigle, Md Pa 1717 Village Park Dr Orangeburg SC 29118-2475 Ph: (803) 533-0091 | Gordon R. Weigle, Md Pa 1717 Village Park Dr Orangeburg SC 29118-2475 Ph: (803) 533-0091 |
| NPI Number | 1174795900 |
|---|---|
| Provider Enumeration Date | 04/01/2008 |
| Last Update Date | 04/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174795900 | NPI | - | NPPES |
| GP3708 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | SC8901 (South Carolina) | Primary |
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