Healthcare Provider Details

I. General information

NPI: 1144114521
Provider Name (Legal Business Name): MATTHEW THOMAS DAVIS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 24TH AVE S
NASHVILLE TN
37212-2637
US

IV. Provider business mailing address

1210 MAIN ST N
CARTHAGE TN
37030-1037
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-4751
  • Fax:
Mailing address:
  • Phone: 615-735-2223
  • Fax: 615-735-1070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number48874
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: