Provider Demographics
NPI:1306007604
Name:WEATHERBY, WILLIAM COLEMAN (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:COLEMAN
Last Name:WEATHERBY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11705 AIRPORT WAY STE 205
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-2710
Mailing Address - Country:US
Mailing Address - Phone:512-522-7708
Mailing Address - Fax:512-233-0824
Practice Address - Street 1:11705 AIRPORT WAY STE 205
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-2710
Practice Address - Country:US
Practice Address - Phone:512-522-7708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN60942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry