Healthcare Provider Details

I. General information

NPI: 1790601375
Provider Name (Legal Business Name): DR. LISA ELLEN DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 N CAMPBELL AVE
TUCSON AZ
85719-1454
US

IV. Provider business mailing address

1295 NORTH MARTIN AVE
TUCSON AZ
85721-0202
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-2873
  • Fax:
Mailing address:
  • Phone: 520-626-5625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberS007896
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: