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General NPI Number Information
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NPI Number | 1588383350
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Entity Type | Organization
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Legal Business Name | WEAVER MEDICAL
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 231 S FAIRMONT AVE
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City | MORRISTOWN
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State | TN
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Zip | 37813-2036
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Country | US
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Telephone | 423-839-1600
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Fax | 423-839-1602
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Provider Business Mailing Address
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Address Line | PO BOX 63
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City | MORRISTOWN
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State | TN
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Zip | 37815-0063
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Country | US
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Telephone | 865-748-6208
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Fax | 423-839-1602
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Authorized Official
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Title or Position | OWNER
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Name | KRYSTAL E. WEAVER
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Credential | PA-C
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Telephone | 865-748-6208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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