GORDON R. WEIGLE, MD PA (NPI# 1174795900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174795900 |
| Entity Type | Organization |
| Organization Name | GORDON R. WEIGLE, MD PA |
| Practice Address |
1717 Village Park Dr Orangeburg SC 29118-2475 |
| Practice Telephone | 8035330091 |
| Practice Fax Number | 8035336084 |
| Mailing Telephone | 8035330091 |
| Mailing Fax Number | 8035336084 |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-04-02 |
| Authorized Official Name | DR. GORDON REESE WEIGLE II (OWNER) |
| Authorized Official Telephone | 8035330091 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
SC8901 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP3708 | 05 |
| Street Address |
1717 VILLAGE PARK DR |
| City | ORANGEBURG |
| State | SC |
| Zip Code | 29118-2475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790925634 | Comprehensive Foot Care of Orangeburg | Clinic/Center | 1717 Village Park Dr, Orangeburg, SC 29118-2475 | 2009-03-05 |
| 1447498621 | Khadijah Halima Allen | Podiatrist | 1717 Village Park Dr, Orangeburg, SC 29118-2475 | 2009-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386268175 | Sharon Y Tremble | Speech-Language Pathologist | 222 Summit Parkway, Orangeburg, SC 29118 | 2020-06-08 |
| 1922658756 | Orangeburg County School District | Local Education Agency (LEA) | 102 Founders Court, Orangeburg, SC 29118 | 2019-09-13 |
| 1710442967 | Central Carolina Endodontics Pa | Dentist | 888 Cook Road, Orangeburg, SC 29118 | 2019-02-01 |
| 1821572009 | Sharon Fogle | Counselor | 2319 Wt. Matthews Road, Orangeburg, SC 29118 | 2018-09-24 |
| 1104320001 | South Carolina Surgical Pa | Surgery | 3045 St Matthews Road, Orangeburg, SC 29118 | 2018-03-23 |
| 1477056794 | Palmetto Moon Anesthesia, LLC | Anesthesiology | 3045 St. Matthews Rd., Orangeburg, SC 29118 | 2018-03-13 |
| 1730691882 | Bio-medical Applications of South Carolina, Inc. | Clinic/Center | 125 Kinard St, Orangeburg, SC 29118 | 2017-10-30 |
| 1154862746 | Latasha Hott | Nurse Practitioner | 2323 St. Matthews Rd, Orangeburg, SC 29118 | 2017-03-15 |
| 1154786960 | R Dale Padgett Md Pa | Clinic/Center | 1727 Villagepark Dr, Orangeburg, SC 29118 | 2015-12-21 |
| 1881977726 | Ontime Transport LLC | Non-emergency Medical Transport (VAN) | 2851 Pelham Ct, Orangeburg, SC 29118 | 2011-09-27 |
| Find all providers in zip 29118 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669027595 | Ketamine Treatment Services | Family Medicine | 3015 Dunes West Blvd Ste 510, Mount Pleasant, SC 29466-8252 | 2019-08-07 |
| 1487213724 | Greater Greenwood United Ministry | Family Medicine | 1404 Edgefield Street, Greenwood, SC 29646 | 2019-06-11 |
| 1164995346 | Rachelle Shepard | Family Medicine | 144 Whitehurst Way, Columbia, SC 29229-8500 | 2019-01-10 |
| 1255848834 | Mobile Medical LLC | Family Medicine | 1002 Shipmaster Ave, Myrtle Beach, SC 29579-5142 | 2018-01-04 |
| 1891035416 | Donald F Wade | Family Medicine | 1728 Vassar Dr, Charleston, SC 29407-4236 | 2013-02-19 |
| 1770880486 | James Stuart Mcdaniel | Family Medicine | 1140 Pilot Boy, Wadmalaw Island, SC 29487-6993 | 2011-02-15 |
| 1356672927 | Bledsoe Family Medicine LLC | Family Medicine | 669 Barr Rd Ste C, Lexington, SC 29072-2369 | 2010-01-21 |
| 1295974509 | John Browning Mcree | Family Medicine | S Carolina Dept of Corrections, Redemption Way, Mc Cormick, SC 29899-0001 | 2009-02-10 |
| 1437370061 | Samuel Johnston Orr | Family Medicine | 140 Forest Hills Dr, Gaffney, SC 29340-2837 | 2007-05-01 |
| 1780613455 | Paul Manuel Espinoza | Family Medicine | 2660 Kinard St, Newberry, SC 29108-2912 | 2006-07-03 |
| Find all providers with the same taxonomy | ||||
| City | ORANGEBURG |
| Zip Code | 29118 |
Please comment or provide details below to improve the information on GORDON R. WEIGLE, MD PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.