Provider Demographics
NPI:1265895916
Name:WEAVER HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:WEAVER HEALTH SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:423-827-2157
Mailing Address - Street 1:7566 NASHVILLE STREET
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736
Mailing Address - Country:US
Mailing Address - Phone:706-935-3600
Mailing Address - Fax:
Practice Address - Street 1:7566 NASHVILLE ST
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2361
Practice Address - Country:US
Practice Address - Phone:234-827-2157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEAVER HEALTH SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-31
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty