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NPI Code Detail

MEDICARE: CODY R WEAVER

MEDICARE: CODY R WEAVER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician77099AZ
2207RH0003XHematology & Oncology Physician77099AZ
3207RX0202XMedical Oncology Physician77099AZ

General Provider Information

NPI Number : 1366973851
Entity Type Code : Individual
Provider Name (Legal Business Name) : CODY R WEAVER
Provider Business Mailing Address
First Line : PO BOX 33269
Second Line :
City : PHOENIX
State : AZ
Zip : 85067-3269
Country : US
Telephone Number : 602-406-4786
Fax Number : 916-636-4358
Provider Business Practice Location Address
First Line : 625 N 6TH ST STE 300
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-3066
Country : US
Telephone Number : 602-406-8222
Fax Number : 602-604-4722
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2017
Last Update Date : 06/08/2026

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Directions to “ CODY R WEAVER ” Practice Location

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