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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

NPI # 1841508918
LBN Legal business name JACK E WEAVER, MD PC
Authorized official JACK WEAVER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/22/2010
Last updated 08/25/2015 - About 11 years ago
Identifiers
OK Medicaid 100088830A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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