Weaver, Keith Andrew

Weaver, Keith Andrew is an sole proprietor health care provider with primary practice located at 1013 Executive Dr Suite 101, Hixson TN 37343-7912. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Independent Medical Examiner, Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Weaver, Keith Andrew can be contacted via phone (423) 875-2538.

Contact Information

Primary practice address
1013 Executive Dr Suite 101 Hixson TN 37343-7912
Phone: (423) 875-2538
Fax: (423) 875-2539
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Independent Medical Examiner 202C00000X 0102201853 Virginia
Allopathic & Osteopathic Physicians / General Practice 208D00000X 2076 Tennessee
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 2076 Tennessee

Profile Details

NPI number 1265652317
LBN Legal business name Weaver, Keith Andrew
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 30th, 2007
Last updated Feb 7th, 2017 - about 8 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 1265652317 NPPES
Tennessee MEDICAID 1519501

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