NPI 1053783068

Jason Weaver

Practitioner Physician Assistant Caldwell, ID

Practice location

Address: 2609 S 10th Ave, Caldwell, ID 83605-6816
Phone: (208) 454-2771
Mailing address: 702 Sunset Dr, Ontario, OR 97914-3121

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

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Registry record

NPI: 1053783068
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Oct 2015
Record last updated: 29 Oct 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.