Weaver, Blake

Weaver, Blake is an individual health care provider with primary practice located at 902 S Bryant Ave , Edmond OK 73034-5742. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Weaver, Blake can be contacted via phone (405) 348-1900.

Contact Information

Primary practice address
902 S Bryant Ave Edmond OK 73034-5742
Phone: (405) 348-1900
Fax: (405) 348-0423
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 4267 Oklahoma
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 4267 Oklahoma

Profile Details

NPI number 1497785893
LBN Legal business name Weaver, Blake
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Aug 18th, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497785893 NPPES
Oklahoma MEDICAID 200058090A

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