Weaver, William Jackson
Weaver, William Jackson is an sole proprietor health care provider with primary practice located at 1754 Lake Hall Road , Lake Village AR 71653. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Weaver, William Jackson can be contacted via phone (870) 265-2669.Contact Information
Primary practice address
1754 Lake Hall Road
Lake Village AR 71653
Phone: (870) 265-2669
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | C-2361 | Arkansas |
Profile Details
| NPI number | 1114259041 |
|---|---|
| LBN Legal business name | Weaver, William Jackson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 3rd, 2010 |
| Last updated | Feb 3rd, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114259041 | NPPES |
| Arkansas | MEDICAID | 101402001/W-38 |
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