Provider Demographics
NPI:1194847855
Name:WEAVER ASSOCIATES, PC
Entity Type:Organization
Organization Name:WEAVER ASSOCIATES, PC
Other - Org Name:CHATHAM FAMILY EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:ALTICE
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:434-432-9752
Mailing Address - Street 1:13995 US HIGHWAY 29
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHATHAM
Mailing Address - State:VA
Mailing Address - Zip Code:24531-5278
Mailing Address - Country:US
Mailing Address - Phone:434-432-9752
Mailing Address - Fax:434-432-8580
Practice Address - Street 1:13995 US HIGHWAY 29
Practice Address - Street 2:SUITE 100
Practice Address - City:CHATHAM
Practice Address - State:VA
Practice Address - Zip Code:24531-5278
Practice Address - Country:US
Practice Address - Phone:434-432-9752
Practice Address - Fax:434-432-8580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001011152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU81078Medicare UPIN