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NPI Code Detail

MEDICARE: DR. RANDALL A DAVIS MD

MEDICARE: DR. RANDALL A DAVIS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician19725TN
22085N0904XNuclear Radiology Physician19725TN
32085N0904XNuclear Radiology Physician14801MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174526339
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDALL A DAVIS MD
Provider Business Mailing Address
First Line : 7695 POPLAR PIKE
Second Line : SUITE 101
City : MEMPHIS
State : TN
Zip : 38138-5947
Country : US
Telephone Number : 901-685-2696
Fax Number : 901-682-9747
Provider Business Practice Location Address
First Line : 7695 POPLAR PIKE
Second Line : SUITE 101
City : GERMANTOWN
State : TN
Zip : 38138-5947
Country : US
Telephone Number : 901-685-2696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 08/03/2016

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