Provider Demographics
NPI:1902838550
Name:WEIKERT, DANIEL S (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:S
Last Name:WEIKERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 COVEY DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5665
Mailing Address - Country:US
Mailing Address - Phone:615-791-0060
Mailing Address - Fax:
Practice Address - Street 1:100 COVEY DR
Practice Address - Street 2:SUITE 107
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5665
Practice Address - Country:US
Practice Address - Phone:615-791-0060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000025541207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3707128Medicaid
TNG07566Medicare UPIN
TN3707128Medicaid