Provider Demographics
NPI:1366972135
Name:WEINAND, JAMIE DREW (MD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:DREW
Last Name:WEINAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ROSE
Other - Last Name:WEINAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:839 W CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2819
Mailing Address - Country:US
Mailing Address - Phone:520-670-3909
Mailing Address - Fax:520-309-2560
Practice Address - Street 1:3655 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2933
Practice Address - Country:US
Practice Address - Phone:520-670-3909
Practice Address - Fax:520-309-2560
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2019-0662207QA0401X
AZ59481207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ59481OtherMEDICAL LICENSE
MA284696OtherMEDICAL LICENSE
NMCS00227635OtherNEW MEXICO CONTROLLED SUBSTANCE LICENSE
NMMD2019-0662OtherNEW MEXICO MEDICAL LICENSE
NMFW9334397OtherDEA - NEW MEXICO DEPARTMENT OF HEALTH ONLY, FEE EXEMPT
AZ59481OtherMEDICAL LICENSE