Jeremy Blake Weaver, P.A.

NPI #1790014447 in Van Buren, Arkansas

Provider Information

NPI Number: 1790014447
Entity Type: Individual
Name: Jeremy Blake Weaver, P.A.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A.
Enumeration Date: Dec 9, 2009
Last Updated: Jan 26, 2021

Practice Location

Address: 620 BROADWAY ST
City: Van Buren
State: Arkansas
ZIP Code: 72956-5830
Phone: (479) 474-5061

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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