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Dr. Jake Thomas Weaver, DO
Student in an Organized Health Care Education/Training Program in Kingsport, Tennessee
NPI 1376286559

Jake Thomas Weaver is a Student in an Organized Health Care Education/Training Program based in Kingsport, TN. Jake Thomas Weaver practices in Kingsport, TN and has the professional credentials of DO. The NPI Number for Jake Thomas Weaver is 1376286559 and holds a License No. (Tennessee).

The current practice location address for Jake Thomas Weaver is 102 E Ravine Rd, Kingsport, TN and can be reached out via phone at 423-245-9600 and via fax at 423-245-9634.

Location: 102 E Ravine Rd, Kingsport, TN, 37660-3814
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1376286559
Provider Name
Jake Thomas Weaver
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
102 E Ravine Rd, Kingsport, TN, 37660-3814
Phone Number
423-245-9600
Fax Number
423-245-9634
Provider Enumeration Date
04/15/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
102 E Ravine Rd
City
Kingsport
State
Tennessee
Zip
37660-3814
Phone Number
423-245-9600
Fax Number
423-245-9634
person
Provider Business Mailing Address Details
Address
102 E Ravine Rd
City
Kingsport
State
Tennessee
Zip
37660-3814
Phone Number
423-245-9600
Fax Number
423-245-9634
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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