Individual
JASON ANDREW WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6286 BRIARCREST AVE STE 200, MEMPHIS, TN 38120-4023
(901) 259-1600
(901) 259-1698
Mailing address
6077 PRIMACY PKWY STE 140, MEMPHIS, TN 38119-5754
(901) 725-8347
(901) 259-7637
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
20411
MS
207T00000X
Neurological Surgery Physician
Primary
42019
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20411
STATE MEDICAL LICENSE
MS
05
—
300267
—
TN
01
—
42019
STATE MEDICAL LICENSE
TN
Enumeration date
01/23/2007
Last updated
12/16/2024
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