Healthcare Provider Details

I. General information

NPI: 1053609198
Provider Name (Legal Business Name): ASHLEY CHARLOTTE DAVIS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2011
Last Update Date: 07/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N PHILLIPS AVE 5100
OKLAHOMA CITY OK
73104-4600
US

IV. Provider business mailing address

1200 NORTH PHILLIPS AVENUE 5100
OKLAHOMA CITY OK
73104-4600
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-8001
  • Fax: 405-271-8697
Mailing address:
  • Phone: 405-271-8001
  • Fax: 405-271-8697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: