Provider Demographics
NPI:1396565461
Name:WEEMS, JARRED JAY (KCPM)
Entity type:Individual
Prefix:
First Name:JARRED
Middle Name:JAY
Last Name:WEEMS
Suffix:
Gender:M
Credentials:KCPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 W DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67213-2407
Mailing Address - Country:US
Mailing Address - Phone:316-941-9948
Mailing Address - Fax:
Practice Address - Street 1:3737 W DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-2407
Practice Address - Country:US
Practice Address - Phone:316-941-9948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist