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General NPI Number Information
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NPI Number | 1043234768
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Entity Type | Individual
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Provider Name | DAVID RICHARD DAVIS MD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 655 W. 8TH STREET DEPARTMENT OF EMERGENCY MEDICINE
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City | JACKSONVILLE
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State | FL
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Zip | 32209
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Country | US
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Telephone | 904-244-5504
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Fax | 904-244-4508
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Provider Business Mailing Address
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Address Line | 655 W. 8TH STREET DEPARTMENT OF EMERGENCY MEDICINE
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City | JACKSONVILLE
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State | FL
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Zip | 32209
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Country | US
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Telephone | 904-244-5504
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Fax | 904-244-4508
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME96442
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License Number State | FL
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