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Contact Information

JACK E WEAVER, MD PC
209 S 36TH ST
MUSKOGEE, OK74401-5043
 Phone: 918-682-7717
 Fax: 918-682-9434
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

207RS0010X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for JACK E WEAVER MD PC · (Female)

NPI Number 1841508918
Status Active
Credentials
Entity Individual
Enumeration date 09/22/2010
Last updated 08/25/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • OK Medicaid 100088830A
Hospital affiliation(s) Not Available
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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