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Individual

DR. ANTHONY ARTHUR WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2003 COMMERCE DR, KINGSLAND, GA 31548-6767
(912) 882-3040
(912) 882-3786
Mailing address
1950 OLD GALLOWS RD, SUITE 520, VIENNA, VA 22182-3990
(703) 847-8899
(703) 991-0514

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002773
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OPT002773
STATE LICENSE
GA
Enumeration date
08/05/2013
Last updated
02/16/2018
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