Jack Eugene Weaver in Muskogee - Specialist
Jack Eugene Weaver - NPI 1902802101
Jack Eugene Weaver is a Specialist in Muskogee, Oklahoma. Jack Eugene Weaver practices all healthcare services and medical treatments related to Specialist. The NPI Number for Jack Eugene Weaver is 1902802101. The last update date is 2018-04-10.
Jack Eugene Weaver's current location address is 209 S 36th St, Muskogee, Oklahoma. You can contact this provider via phone number 9186827717 and fax number 9186829434. The mailing address for Jack Eugene Weaver is 209 S 36th St, Muskogee, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack Eugene Weaver |
|---|---|
| Address | 209 S 36th St, Muskogee, Oklahoma |
| Phone Number | 9186827717 |
| Fax Number | 9186829434 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1902802101 |
|---|---|
| Provider Enumeration Date | 2005-06-22 |
| Last Updated Date | 2018-04-10 |
Provider Mailing Address Detail
| Address | 209 S 36th St |
|---|---|
| City | Muskogee |
| State | Oklahoma (OK) |
| Post Code | 744015043 |
| Phone Number | 9186827717 |
| Fax Number | 9186829434 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 19721 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100088830A | OK | -- | |
| 1841508918 | OK | GROUP NPI |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Jack Eugene Weaver by the Centers for Medicare & Medicaid Services?
The Jack Eugene Weaver has been issued the NPI (National Provider Identifier) 1902802101, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Jack Eugene Weaver's physical address?
The Jack Eugene Weaver is physically located at 209 S 36Th St, in the city of Muskogee, OK, with the postal code 744015043.
What is Jack Eugene Weaver's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Jack Eugene Weaver is Specialist, and the taxonomy code that classifies this field of practice is 174400000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1902802101 to Jack Eugene Weaver?
The Centers for Medicare & Medicaid Services assigned the 1902802101 to Jack Eugene Weaver on 2005-06-22.
As of what date were the Jack Eugene Weaver's details last updated?
The information pertaining to the Jack Eugene Weaver, including its address, specialty, and other details, was most recently updated on 2018-04-10.