Individual
DR. KRISTIN JACLYN WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216
(601) 984-5700
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5706
(601) 984-5733
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
25798
MS
207T00000X
Neurological Surgery Physician
MD45234
PA
207T00000X
Neurological Surgery Physician
ME112461
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017646400
—
FL
Enumeration date
07/01/2010
Last updated
11/14/2018
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