Organization
PULMONARY ASSOCIATES OF NORTHWESTERN ARIZONA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN MARIE WEAVER MD (MEMBER)
(928) 257-1864
Entity
Organization
Contact information
Practice address
1791 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403-5648
(928) 257-1864
(928) 855-0188
Mailing address
PO BOX 838, LAKE HAVASU CITY, AZ 86405-0838
(928) 257-1864
(928) 855-0188
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
33312
AZ
207RP1001X
Pulmonary Disease Physician
Primary
33312
AZ
Other
Enumeration date
08/07/2009
Last updated
08/15/2019
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