Healthcare Provider Details

I. General information

NPI: 1215903802
Provider Name (Legal Business Name): RYAN G. DAVIS PHARM.D., BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLERMONT ST
DENVER CO
80220-3808
US

IV. Provider business mailing address

2227 GOLD DUST LN
HIGHLANDS RANCH CO
80129-5712
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-8020
  • Fax: 303-393-4624
Mailing address:
  • Phone: 303-791-6744
  • Fax: 303-471-1540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number13788
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: