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General NPI Number Information
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NPI Number | 1487854188
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Entity Type | Organization
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Legal Business Name | STEPHEN O. DAVIS, M.D., INC
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 10/30/2008
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Provider Practice Location Address
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Address Line | 6081 N 1ST ST STE 102
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City | FRESNO
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State | CA
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Zip | 93710-5466
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Country | US
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Telephone | 559-431-5653
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Fax |
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Provider Business Mailing Address
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Address Line | 6081 N 1ST ST STE 102
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City | FRESNO
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State | CA
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Zip | 93710-5466
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Country | US
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Telephone | 559-431-5653
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICES
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Name | DR. STEPHEN OWEN DAVIS
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Credential | M.D.
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Telephone | 559-431-5653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | G300220
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License Number State | CA
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