Individual
DR. KEITH ANDREW WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1013 EXECUTIVE DR, SUITE 101, HIXSON, TN 37343-7912
(423) 875-2538
(423) 875-2539
Mailing address
1013 EXECUTIVE DR, SUITE 101, HIXSON, TN 37343-7912
(423) 875-2538
(423) 875-2539
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
0102201853
VA
207R00000X
Internal Medicine Physician
2076
TN
208D00000X
General Practice Physician
Primary
2076
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1519501
—
TN
Enumeration date
04/30/2007
Last updated
02/07/2017
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