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General NPI Number Information
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NPI Number | 1447780010
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Entity Type | Individual
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Provider Name | GEORGE DAVIS IDE MD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2017
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 10844 N 23RD AVE STE 100&200
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City | PHOENIX
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State | AZ
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Zip | 85029-4939
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Country | US
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Telephone | 602-685-6000
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Fax | 602-808-2799
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Provider Business Mailing Address
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Address Line | 3003 N CENTRAL AVE STE 400
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City | PHOENIX
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State | AZ
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Zip | 85012-2929
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Country | US
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Telephone | 602-685-6000
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Fax | 602-302-7925
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 308088
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 69790
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License Number State | AZ
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