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Individual

DR. RANDALL W WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2400 HOSPITAL RD, TUSKEGEE, AL 36083-5001
(334) 272-4670
Mailing address
215 PERRY HILL RD, MONTGOMERY, AL 36109-3725
(334) 272-4670
(334) 273-6202

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00016642
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051527706
AL
Enumeration date
10/04/2006
Last updated
07/17/2018
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