Provider Demographics
NPI:1265624621
Name:WEAVER, MICHELLE CATHEY (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:CATHEY
Last Name:WEAVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613A HIGHWAY 278 W
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:AR
Mailing Address - Zip Code:71671-9185
Mailing Address - Country:US
Mailing Address - Phone:870-820-2313
Mailing Address - Fax:
Practice Address - Street 1:613A HIGHWAY 278 W
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:AR
Practice Address - Zip Code:71671-9185
Practice Address - Country:US
Practice Address - Phone:870-820-2313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-5904207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine