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General NPI Number Information
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NPI Number | 1457924789
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Entity Type | Individual
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Provider Name | RYAN DAVIS AA
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Gender | Male
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Dates
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Enumeration Date | 07/23/2021
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Last Update Date | 11/03/2021
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Provider Practice Location Address
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Address Line | 7700 S BROADWAY
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City | LITTLETON
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State | CO
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Zip | 80122-2602
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Country | US
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Telephone | 303-730-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 45 SHERINGTON PL
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City | ATLANTA
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State | GA
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Zip | 30350-4741
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Country | US
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Telephone | 770-861-5303
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Fax |
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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 | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | ANT.0000162
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License Number State | CO
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