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

Jack Eugene Weaver, MD

Individual provider Specialist · NPI 1902802101

Jack Eugene Weaver, MD is an Interventional Pain Management in Muskogee, Oklahoma. Graduated from Michigan State University College of Osteopathic Medicine in 1993, 33 years ago. Accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
33
Trained at
Michigan State University College of Osteopathic Medicine
Licensed in
OK
In the registry since
2005
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

209 S 36th St
Muskogee, OK 74401-5043
Phone: (918) 710-4112
Fax: (918) 710-4118
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Pain Medicine Physician (primary) Taxonomy 208VP0014X · Licence 19721 (OK)
Specialist Taxonomy 174400000X · Licence 19721 (OK)
Family Medicine Physician Taxonomy 207Q00000X · Licence 19721 (OK)

Record details

NPI number1902802101
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 22, 2005
Last updated in NPPESFebruary 4, 2026
Certification dateFebruary 4, 2026
Mailing address4750 S Garnett Rd, Tulsa, OK 74146-5222

Medicare enrollment

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

Medicare specialtyINTERVENTIONAL PAIN MANAGEMENT
Also practisesSPORTS MEDICINE
Medical schoolMICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 1993 (33 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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