Provider Demographics
NPI:1366523433
Name:WEILBAECHER, THOMAS G (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:G
Last Name:WEILBAECHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9613 GARDEN OAK LN
Mailing Address - Street 2:
Mailing Address - City:RIVER RIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70123-2005
Mailing Address - Country:US
Mailing Address - Phone:504-737-8564
Mailing Address - Fax:
Practice Address - Street 1:1555 POYDRAS ST
Practice Address - Street 2:SUITE 1300
Practice Address - City:NEW ORLRANS
Practice Address - State:LA
Practice Address - Zip Code:70112
Practice Address - Country:US
Practice Address - Phone:504-556-7160
Practice Address - Fax:504-589-5289
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD013289207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology