Individual
MR. ROGER LOUIS WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8491 HOSPITAL DR, 176, DOUGLASVILLE, GA 30134-2412
(706) 645-1046
(877) 898-1518
Mailing address
1009 3RD AVE, WEST POINT, GA 31833-1215
(706) 645-1046
(877) 898-1518
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1530
GA
Other
Enumeration date
02/02/2007
Last updated
01/07/2013
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