Provider Demographics
NPI:1710974944
Name:WEEMS, DAVE DREW (DO)
Entity type:Individual
Prefix:DR
First Name:DAVE
Middle Name:DREW
Last Name:WEEMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 RIDGE ROCK DR
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72802-2226
Mailing Address - Country:US
Mailing Address - Phone:417-761-9659
Mailing Address - Fax:
Practice Address - Street 1:524 W SAGAMORE AVE OFC
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-3514
Practice Address - Country:US
Practice Address - Phone:863-983-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS21357208M00000X
MO114747207Q00000X
ARE-5759208M00000X
ARE5759207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR175106003Medicaid
MO505488601Medicaid
MO505488601Medicaid
AR5H306Medicare PIN