R Wyatt Weaver Jr,M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01023520A Issued in IN

Legal business name

R WYATT WEAVER JR,M.D.

Practice address

306 E Maumee St
Ste 8
Angola, IN 46703-2038

Phone

(260) 665-1337

NPI assigned

Aug 14, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. R Wyatt Weaver Jr., M.D.

Title

Owner

Phone

(260) 665-1337

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1831381813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E MAUMEE ST",
            "address_2": "STE 8",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032038",
            "telephone_number": "260-665-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E MAUMEE ST",
            "address_2": "STE 8",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032038",
            "telephone_number": "260-665-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R WYATT WEAVER JR,M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-08-14",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "R WYATT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-665-1337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01023520A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Angola, IN
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• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.