| Doctor Name: | VICKY LYNN WEIDNER |
| NPI Number: | 1770540221 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 15349 |
| Business Practice Address: | 6767 S Yale Ave Ste B Physician Services Of Physical Therapy Of Tulsa Tulsa, OK - 741363302 |
| Business Phone Number: | 9184943000 |
| Business Fax Number: | 9184940003 |
| Mailing Address: | 6767 S Yale Ave Ste B, TULSA |
| State: | OK |
| Postal Code: | 741363302 |
| Phone Number: | 9184943000 |
| Fax Number: | 9184940003 |
| NPI Enumeration Date: | 04/27/2006 |
| NPI Last Update Date: | 04/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 15349 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |