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William Jackson Weaver, MD
General Practice Physician in Lake Village, Arkansas
NPI 1114259041

William Jackson Weaver is a General Practice Physician based in Lake Village, AR. William Jackson Weaver practices in Lake Village, AR and has the professional credentials of MD. The NPI Number for William Jackson Weaver is 1114259041 and holds a License No. C-2361 (Arkansas).

The current practice location address for William Jackson Weaver is 1754 Lake Hall Road, Lake Village, AR and can be reached out via phone at 870-265-2669.

Location: 1754 Lake Hall Road, Lake Village, AR, 71653
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114259041
Provider Name
William Jackson Weaver
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1754 Lake Hall Road, Lake Village, AR, 71653
Phone Number
870-265-2669
Fax Number
Provider Enumeration Date
02/03/2010
Last Update Date
11/16/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
101402001/W-38 05 AR
institution
Provider Business Practice Location Address Details
Address
1754 Lake Hall Road
City
Lake Village
State
Arkansas
Zip
71653
Phone Number
870-265-2669
Fax Number
person
Provider Business Mailing Address Details
Address
1754 Lake Hall Road
City
Lake Village
State
Arkansas
Zip
71653
Phone Number
870-265-2669
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
C-2361 (Arkansas)
Definition
Definition to come...
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