Healthcare Provider Details

I. General information

NPI: 1811162936
Provider Name (Legal Business Name): DAVIS FOOT AND ANKLE CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 01/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 NORTHCREST DR
SPRINGFIELD TN
37172-3963
US

IV. Provider business mailing address

PO BOX 1455
SPRINGFIELD TN
37172-1455
US

V. Phone/Fax

Practice location:
  • Phone: 615-384-3112
  • Fax: 615-384-7332
Mailing address:
  • Phone: 615-384-3112
  • Fax: 615-384-7332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN W DAVIS
Title or Position: OWNER / PROVIDER
Credential: D.P.M.
Phone: 615-384-3112