Healthcare Provider Details

I. General information

NPI: 1003898396
Provider Name (Legal Business Name): STEVEN J DAVIS SR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 N MAIN ST
OPP AL
36467-1632
US

IV. Provider business mailing address

802 N MAIN ST
OPP AL
36467-1632
US

V. Phone/Fax

Practice location:
  • Phone: 334-493-3240
  • Fax: 334-493-9535
Mailing address:
  • Phone: 334-493-3240
  • Fax: 334-493-9535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number32248
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD7403
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO263
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: