Healthcare Provider Details

I. General information

NPI: 1932194131
Provider Name (Legal Business Name): SCOTT H DAVIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 05/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 TULANE AVE 5TH FLOOR PEDIATRIC CLINIC
NEW ORLEANS LA
70112-2600
US

IV. Provider business mailing address

1430 TULANE AVE SL-37
NEW ORLEANS LA
70112-2632
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-6453
  • Fax:
Mailing address:
  • Phone: 504-988-5601
  • Fax: 504-988-5490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number17854
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number06074R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: