Healthcare Provider Details

I. General information

NPI: 1386627636
Provider Name (Legal Business Name): THOMAS HOOKS DAVISON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 05/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 PANSY ST SW
HUNTSVILLE AL
35801-3803
US

IV. Provider business mailing address

PO BOX 2289
HUNTSVILLE AL
35804-2289
US

V. Phone/Fax

Practice location:
  • Phone: 256-536-9587
  • Fax: 256-536-9588
Mailing address:
  • Phone: 256-536-9587
  • Fax: 256-536-9588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number16417
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: