Basic Information
| Provider Information | |||||||||
| NPI: | 1114965852 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WEAVER EYE ASSOCIATES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2700 EASTERN BLVD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174022906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177577023 | ||||||||
| FaxNumber: | 7177576517 | ||||||||
| Practice Location | |||||||||
| Address1: | 2700 EASTERN BLVD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174022906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177577023 | ||||||||
| FaxNumber: | 7177576517 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 03/15/2013 | ||||||||
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| AuthorizedOfficialLastName: | WEAVER | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7177577023 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | O.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.