Provider Demographics
NPI:1023305554
Name:WEAVER, JAMES PATRICK (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PATRICK
Last Name:WEAVER
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Gender:M
Credentials:DMD
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Mailing Address - Street 1:3020 HARTLEY RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257
Mailing Address - Country:US
Mailing Address - Phone:904-264-5437
Mailing Address - Fax:904-485-8417
Practice Address - Street 1:112 BARTRAM OAKS WALK
Practice Address - Street 2:SUITE 203
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32259
Practice Address - Country:US
Practice Address - Phone:904-264-5437
Practice Address - Fax:904-485-8417
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2020-09-02
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Provider Licenses
StateLicense IDTaxonomies
FLDN194031223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry