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General NPI Number Information
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NPI Number | 1467185561
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Entity Type | Individual
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Provider Name | SPENCER WOOD DAVIDSON
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Gender | Male
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Dates
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Enumeration Date | 07/06/2022
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | KU HEALTH SYSTEM 4000 CAMBRIDGE STREET
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City | KANSAS CITY
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State | KS
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Zip | 66160-0001
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Country | US
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Telephone | 913-588-1227
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Fax |
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Provider Business Mailing Address
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Address Line | 5314 W 71ST TER
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-2335
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Country | US
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Telephone | 417-529-0069
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 2023040434
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 43-5579-79-121
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License Number State | KS
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