Weiss, Jack Gilbert

Weiss, Jack Gilbert is an individual health care provider with primary practice located at 77 W Forest Ave Suite 207, Flagstaff AZ 86001-1479. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Weiss, Jack Gilbert can be contacted via phone (928) 773-2505.

Contact Information

Primary practice address
77 W Forest Ave Suite 207 Flagstaff AZ 86001-1479
Phone: (928) 773-2505
Fax: (928) 773-2504
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X CRNA0011 Arizona

Profile Details

NPI number 1174534754
LBN Legal business name Weiss, Jack Gilbert
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2006
Last updated Feb 5th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174534754 NPPES
Arizona MEDICAID 363242

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