Provider Demographics
NPI:1568609287
Name:WEATHERFORD, ALAN DAVIS (PA-C)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:DAVIS
Last Name:WEATHERFORD
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:9486 HIGHWAY 412 W
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-5713
Mailing Address - Country:US
Mailing Address - Phone:731-968-0984
Mailing Address - Fax:731-967-9764
Practice Address - Street 1:200 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-2038
Practice Address - Country:US
Practice Address - Phone:731-968-3646
Practice Address - Fax:731-968-1870
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2024-06-07
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Provider Licenses
StateLicense IDTaxonomies
TN1676207P00000X, 207Q00000X, 207R00000X, 208000000X, 208100000X, 2085P0229X, 208600000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No208600000XAllopathic & Osteopathic PhysiciansSurgery