JACK E WEAVER, MD PC
NPI 1841508918
Internal Medicine - Sports Medicine in Muskogee, OK

Active since September 22, 2010CLIA 37D2077468 · Waiver
209 S 36TH ST, MUSKOGEE, OK 74401(918) 682-7717(918) 682-9434 Get Directions Write a Review

NPPES record last updated: August 25, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jack E Weaver, Md Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK E WEAVER, MD PC (NPI 1841508918) is a healthcare organization registered as a sports medicine in Muskogee, Oklahoma and active in the NPI registry since September 2010. The organization holds a CLIA Waiver certificate valid through July 12, 2027 and lists Jack E Weaver, Owner, as its authorized official.

NPPES Registry Identity

NPI1841508918
Entity TypeOrganization
Primary Taxonomy207RS0010X
Legal Business NameJACK E WEAVER, MD PC
Location Address209 S 36TH STMuskogee, OK 74401-5043
Mailing Address209 S 36th StMuskogee, OK 74401-5043 · (918) 682-7717 · Fax (918) 682-9434
Fax(918) 682-9434
Organization SubpartNo
Authorized OfficialJack E WeaverOwner · (918) 682-7717
Enumeration DateSeptember 22, 2010
Last NPPES UpdateAugust 25, 2015
NPI 1841508918 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RS0010X
Definition

An internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual.

209 S 36TH ST, Muskogee, OK 74401

Other Identifiers 2

Medicare NSC6346320001OK
Medicaid100088830AOK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver

Jack E Weaver Md-Pc · Muskogee, OK
Active · expires Jul 12, 2027
CLIA Number37D2077468
Laboratory TypePhysician Office
Certificate Effective DateJuly 13, 2025
Certificate Expiration DateJuly 12, 2027
Laboratory DirectorJack E. Weaver
Laboratory Phone(918) 682-7717
Laboratory LocationJack E Weaver Md-Pc209 S 36th St, Muskogee, OK 74401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location


The following 10 providers are registered at the same or a nearby location.

Specialist
209 S 36TH ST
MUSKOGEE, OK 74401
Orthopaedic Surgery
209 S 36TH ST, SUITE A
MUSKOGEE, OK 74401
Specialist/Technologist (Athletic Trainer)
209 S 36TH ST
MUSKOGEE, OK 74401
Specialist
209 S 36TH ST
MUSKOGEE, OK 74401
Orthopaedic Surgery
209 S 36TH ST
MUSKOGEE, OK 74401
Specialist
209 S 36TH ST
MUSKOGEE, OK 74401
Specialist
209 S 36TH ST
MUSKOGEE, OK 74401
Orthopaedic Surgery
209 S 36TH ST
MUSKOGEE, OK 74401
Surgery
209 S 36TH ST, SUITE A
MUSKOGEE, OK 74401
Pain Medicine (Interventional Pain Medicine)
209 S 36TH ST
MUSKOGEE, OK 74401

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1841508918, enumerated as an "organization" on September 22, 2010.

The provider is located at 209 S 36TH ST MUSKOGEE, OK 74401 and the phone number is (918) 682-7717.

Internal Medicine with taxonomy code 207RS0010X and a focus in Sports Medicine.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.