Healthcare Provider Details

I. General information

NPI: 1215960927
Provider Name (Legal Business Name): DAVIS & DAVIS, CLINICAL PSYCHOLOGISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 WATERMELON RD SUITE 105
NORTHPORT AL
35473-5170
US

IV. Provider business mailing address

3610 WATERMELON RD SUITE 105
NORTHPORT AL
35473-5170
US

V. Phone/Fax

Practice location:
  • Phone: 205-758-7343
  • Fax: 205-758-7558
Mailing address:
  • Phone: 205-758-7343
  • Fax: 205-758-7558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL W DAVIS
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 205-758-7343