Individual
MR. JEFFREY THOMAS WEEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
920 DOUG WHITE DR STE 510, MYRTLE BEACH, SC 29572-4183
(843) 497-7772
(843) 848-7530
Mailing address
920 DOUG WHITE DR STE 510, MYRTLE BEACH, SC 29572-4183
(843) 497-7772
(843) 848-7530
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2063
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1873PA
—
SC
Enumeration date
06/26/2006
Last updated
01/13/2022
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