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NPI Code Detail

MEDICARE: MRS. TIFFANY DAVIS HIS

MEDICARE: MRS. TIFFANY DAVIS HIS
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
1237700000XHearing Instrument SpecialistHA038732MO

General Provider Information

NPI Number : 1558556662
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TIFFANY DAVIS HIS
Provider Business Mailing Address
First Line : 3473 RIDER TRL S
Second Line :
City : EARTH CITY
State : MO
Zip : 63045-1110
Country : US
Telephone Number : 314-328-0088
Fax Number :
Provider Business Practice Location Address
First Line : 5220 S LINDBERGH BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63126-3519
Country : US
Telephone Number : 314-843-7233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2007
Last Update Date : 03/04/2021

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