NPI 1790014447

Jeremy Blake Weaver, PA

Practitioner Physician Assistant Van Buren, AR

Practice location

Address: 620 Broadway St, Van Buren, AR 72956-5830
Phone: (479) 474-5061
Fax: (479) 922-2007

Registered specialties (2)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA-843 (AR)

Other Physician Assistant providers in Arkansas →

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA06492 (TX)

Registry record

NPI: 1790014447
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Dec 2009
Record last updated: 26 Jan 2021

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.