Individual
DR. SHON ANTHONY WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
100 W CAPITOL AVE, PIERRE, SD 57501-2036
(605) 224-0404
Mailing address
100 W CAPITOL AVE, PIERRE, SD 57501-2036
(605) 224-0404
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
745
SD
152W00000X
Optometrist
Primary
779
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26-3478480
TAX ID
MT
01
—
62465
UPIN
—
Enumeration date
07/07/2006
Last updated
05/06/2026
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