| Dr Edgar N Weaver Jr, MD | |
| 5304 Indian Grave Rd Sw, Suite A, Roanoke, VA 24018-9108 | |
| (540) 772-7107 | |
| (540) 772-7858 | 
| Full Name | Dr Edgar N Weaver Jr | 
|---|---|
| Gender | Male | 
| Speciality | Neurological Surgery | 
| Location | 5304 Indian Grave Rd Sw, Roanoke, Virginia | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1346251469 | NPI | - | NPPES | 
| 006196705 | Medicaid | VA | |
| C12923 | Other | RAILROAD MEDICARE LEGACY | |
| 140001855 | Other | RAILROAD MEDICARE | |
| C01334 | Other | VA | MEDICARE LEGACY GROUP NUM | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207T00000X | Neurological Surgery | 0101033189 (Virginia) | Primary | 
| Entity Name | Spine Center Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1548883192 PECOS PAC ID: 6709208507 Enrollment ID: O20200624002553 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Edgar N Weaver Jr, MD 1234 Franklin Rd Sw, Roanoke, VA 24016-4606 Ph: (540) 772-7107 | Dr Edgar N Weaver Jr, MD 5304 Indian Grave Rd Sw, Suite A, Roanoke, VA 24018-9108 Ph: (540) 772-7107 | 
| Dr. John C Fraser, M.D. Neurological Surgery Medicare: Not Enrolled in Medicare Practice Location: 3 Riverside Circle, Roanoke, VA 24016 Phone: 540-224-5170 Fax: 540-985-9612 | |
| Dr. Gary R Simonds, M.D. Neurological Surgery Medicare: Not Enrolled in Medicare Practice Location: 3 Riverside Circle, Roanoke, VA 24016 Phone: 540-224-5170 Fax: 540-985-9612 | |
| Dr. Jonathan Edward Mcneal, DO Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1030 S Jefferson St Ste 106, Roanoke, VA 24016 Phone: 540-343-4092 Fax: 540-343-5052 | |
| Eric Marvin, D.O. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1030 S Jefferson St, Roanoke, VA 24016 Phone: 540-985-3969 | |
| Cara Marie Rogers, DO Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1906 Belleview Ave Se, Roanoke, VA 24014 Phone: 540-981-8345 Fax: 540-344-3812 | |
| Dr. John J Entwistle, D.O. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 2331 Franklin Rd Sw, Roanoke, VA 24014 Phone: 540-224-5170 Fax: 540-344-3016 |