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General NPI Number Information
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NPI Number | 1467600536
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Entity Type | Organization
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Legal Business Name | DR. PARTICIA L DAVIS M.D.
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 1206 W 2ND ST
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City | ROSWELL
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State | NM
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Zip | 88201-2010
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Country | US
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Telephone | 575-623-9330
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Fax | 575-623-5651
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Provider Business Mailing Address
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Address Line | 1206 W 2ND ST
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City | ROSWELL
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State | NM
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Zip | 88201-2010
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Country | US
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Telephone | 575-623-9330
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Fax | 575-623-5651
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Authorized Official
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Title or Position | OWNER
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Name | PARTICIA L DAVIS
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Credential | M. D.
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Telephone | 575-623-9330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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