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General NPI Number Information
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NPI Number | 1326238718
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Entity Type | Individual
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Provider Name | DEREK C DAVIDSON D.O., MSPT
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Gender | Male
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 766 N KING ST STE 2
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City | NORTHAMPTON
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State | MA
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Zip | 01060-1143
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Country | US
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Telephone | 413-860-2305
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Fax | 413-586-1068
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Provider Business Mailing Address
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Address Line | 271 PARK ST
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City | WEST SPRINGFIELD
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State | MA
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Zip | 01089-3311
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Country | US
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Telephone | 413-785-1153
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Fax | 413-781-4951
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 272213
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License Number State | MA
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