Healthcare Provider Details
I. General information
NPI: 1780654459
Provider Name (Legal Business Name): JEFFREY SCOTT WEEKS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/25/2006
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 S FARMERVILLE ST
RUSTON LA
71270-5941
US
IV. Provider business mailing address
1200 S FARMERVILLE ST
RUSTON LA
71270-5941
US
V. Phone/Fax
- Phone: 318-255-3690
- Fax:
- Phone: 318-255-3690
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | 25003 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 2024-02020 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: