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Contact Information

JACK E WEAVER, MD
209 S 36TH ST
MUSKOGEE, OK74401-5043
 Phone: 918-710-4112
 Fax: 918-710-4118
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for JACK E WEAVER · (Male)

NPI # 1902802101
Status Active
Credentials MD
Entity Individual
Enumeration date 06/22/2005
Last updated 02/04/2026 - About 4 months ago
Sole proprietor 1 No
Identifiers
  • OK License # 19721
  • OK Medicaid 100088830A
  • OK Other 1841508918 GROUP NPI
Hospital affiliation(s)
  • MUSKOGEE REGIONAL MEDICAL CENTER - (Acute Care)
    300 ROCKEFELLER DRIVE
    MUSKOGEE, OK 74401
  • SAINT FRANCIS HOSPITAL INC - (Acute Care)
    6161 SOUTH YALE
    TULSA, OK 74136
  • TAHLEQUAH CITY HOSPITAL - (Acute Care)
    1400 EAST DOWNING STREET
    TAHLEQUAH, OK 74465
  • W W HASTINGS INDIAN HOSPITAL - (Acute Care)
    100 S BLISS AVENUE
    TAHLEQUAH, OK 74464
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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