Provider Demographics
NPI:1689179681
Name:GENTRY, WESTON BAIN (MD)
Entity type:Individual
Prefix:
First Name:WESTON
Middle Name:BAIN
Last Name:GENTRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2020 CANYON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1959
Mailing Address - Country:US
Mailing Address - Phone:615-417-9619
Mailing Address - Fax:205-877-8377
Practice Address - Street 1:2020 CANYON RD STE 200
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1959
Practice Address - Country:US
Practice Address - Phone:615-417-9619
Practice Address - Fax:205-877-8377
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL48702207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery