Healthcare Provider Details

I. General information

NPI: 1770543704
Provider Name (Legal Business Name): JAMES BYRON DAVIDSON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 04/23/2020
Certification Date: 04/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 MORTON PLANT ST STE 301
CLEARWATER FL
33756-3395
US

IV. Provider business mailing address

430 MORTON PLANT ST STE 301
CLEARWATER FL
33756-3395
US

V. Phone/Fax

Practice location:
  • Phone: 727-461-6026
  • Fax: 727-461-1492
Mailing address:
  • Phone: 727-461-6026
  • Fax: 727-461-1492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOS8633
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberOS8633
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: