Individual
JACKSON W WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4517 PARK AVE, HOT SPRINGS, AR 71901-9476
(501) 623-7900
(501) 623-7337
Mailing address
1661 AIRPORT RD STE D, HOT SPRINGS, AR 71913-8184
(015) 625-7500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E19265
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/20/2022
Last updated
06/30/2025
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