Provider Demographics
NPI:1770786279
Name:THOMAS A. WEINZAPFEL, MD, LLC
Entity type:Organization
Organization Name:THOMAS A. WEINZAPFEL, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEINZAPFEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-422-6886
Mailing Address - Street 1:2522 WATERBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-3200
Mailing Address - Country:US
Mailing Address - Phone:812-422-6886
Mailing Address - Fax:812-428-5508
Practice Address - Street 1:2522 WATERBRIDGE WAY
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-3200
Practice Address - Country:US
Practice Address - Phone:812-422-6886
Practice Address - Fax:812-428-5508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000228811OtherANTHEM GROUP