Weaver, Kenneth
Weaver, Kenneth is an individual health care provider with primary practice located at 1103 E Jackson Blvd Ste 1, Jonesborough TN 37659. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Weaver, Kenneth can be contacted via phone (423) 753-4177.Contact Information
Primary practice address
1103 E Jackson Blvd Ste 1
Jonesborough TN 37659
Phone: (423) 753-4177
Fax: (423) 753-8030
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | MD11216 | Tennessee |
Profile Details
| NPI number | 1942262167 |
|---|---|
| LBN Legal business name | Weaver, Kenneth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 4th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942262167 | NPPES |
| Tennessee | MEDICAID | 3166800 |
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