Provider Demographics
NPI:1285606889
Name:WEYBRIGHT, WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:WEYBRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 US HIGHWAY 20
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:IN
Mailing Address - Zip Code:46540-9713
Mailing Address - Country:US
Mailing Address - Phone:574-825-8068
Mailing Address - Fax:574-825-4873
Practice Address - Street 1:226 US HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:IN
Practice Address - Zip Code:46540-9713
Practice Address - Country:US
Practice Address - Phone:574-825-8068
Practice Address - Fax:574-825-4873
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01020539A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100361070Medicaid
IN100361070Medicaid
D94726Medicare UPIN