Provider Demographics
NPI:1174600662
Name:WEEKS, REX (PA)
Entity type:Individual
Prefix:
First Name:REX
Middle Name:
Last Name:WEEKS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:780 KUENZLI ST
Mailing Address - Street 2:STE 202
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-0837
Mailing Address - Country:US
Mailing Address - Phone:775-982-4590
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:4791 SUMMIT RIDGE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-7917
Practice Address - Country:US
Practice Address - Phone:775-624-2200
Practice Address - Fax:775-624-2211
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV433363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
11939264OtherCAQH
NV1174600662Medicaid
NVCL504WMedicare PIN