Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dalton Glenn Weaver

Individual provider Physician Assistant · NPI 1104320308

Dalton Glenn Weaver is a Physician Assistant in Jackson, Tennessee. Qualified in 2014, 12 years ago. Practices with Erlanger Health, a 503-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
12
Licensed in
TN
In the registry since
2018

Practice location Address checks out

708 N Highland Ave
Jackson, TN 38301-4829
Phone: (731) 394-0071
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (TN)

Record details

NPI number1104320308
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 21, 2018
Last updated in NPPESAugust 7, 2019
Mailing address109 E Lafayette St, Jackson, TN 38301-6203

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Erlanger Health — 503 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Jackson