Provider Demographics
NPI:1982643425
Name:WEEGAR, JAMES C (PA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:WEEGAR
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 KNOBBY CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-6556
Mailing Address - Country:US
Mailing Address - Phone:239-784-3831
Mailing Address - Fax:
Practice Address - Street 1:630 AMERICAN THREAD RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-8534
Practice Address - Country:US
Practice Address - Phone:828-756-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA0002048363A00000X
NC0010-00519363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL292158800Medicaid
FL292158800Medicaid
S53913Medicare UPIN