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NPI Code Detail

MEDICARE: JAMES R WEAVER R.P.A.C.

MEDICARE: JAMES R WEAVER R.P.A.C.
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
1363A00000XPhysician Assistant009622NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2110055471OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982650230
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES R WEAVER R.P.A.C.
Provider Business Mailing Address
First Line : 1 HOSPITAL DR STE 306
Second Line :
City : LEWISBURG
State : PA
Zip : 17837-9350
Country : US
Telephone Number : 570-522-4110
Fax Number : 570-768-3911
Provider Business Practice Location Address
First Line : 3 HOSPITAL DR STE 100
Second Line :
City : LEWISBURG
State : PA
Zip : 17837-9394
Country : US
Telephone Number : 570-524-5056
Fax Number : 570-524-5061
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 06/08/2022

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