Provider Demographics
NPI:1609946268
Name:WEEKLEY, DOUGLAS GERALD JR (DC)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:GERALD
Last Name:WEEKLEY
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-3585
Mailing Address - Country:US
Mailing Address - Phone:937-866-3281
Mailing Address - Fax:
Practice Address - Street 1:1231 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3585
Practice Address - Country:US
Practice Address - Phone:937-866-3281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH259111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor