Weatherly, Mark Richard
Weatherly, Mark Richard is an individual health care provider with primary practice located at 60 W Gore Street , Orlando FL 32806-1101. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Pulmonology, which is considered as his primary health care specialty. Weatherly, Mark Richard can be contacted via phone (407) 351-5384.Contact Information
Primary practice address
60 W Gore Street
Orlando FL 32806-1101
Phone: (407) 351-5384
Fax: (407) 445-0321
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Pulmonology | 2080P0214X | ME62498 | Florida |
Profile Details
| NPI number | 1881703650 |
|---|---|
| LBN Legal business name | Weatherly, Mark Richard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 29th, 2006 |
| Last updated | Nov 10th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881703650 | NPPES |
| Louisiana | MEDICAID | 1419354 | |
| Louisiana | MEDICAID | 7616163 | |
| Louisiana | MEDICAID | 370776800 | |
| Louisiana | Other | ME62498 |
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