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Tyson Jay Weese

Family Medicine

Allopathic & Osteopathic Physicians

2225 E Evesham Rd, Voorhees, NJ 08043-1557

PECOS Enrollment

This provider is enrolled in PECOS as TYSON WEESE.

Based on the most recent information from CMS, provider Tyson Jay Weese is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1669773206
Provider Type
Individual
Full Name
Weese, Tyson Jay
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
11/13/2010
Last Updated
2/11/2022

Contact Information

Practice Location

2225 E Evesham Rd, Voorhees, NJ 08043-1557

(856) 795-4330

Unlisted Fax

Mailing Location

2225 E Evesham Rd, Voorhees, NJ 08043-1557

(856) 795-4330

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 25MAO8855200 New Jersey

Tyson Jay Weese

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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