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General NPI Number Information
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NPI Number | 1538306725
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Entity Type | Organization
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Legal Business Name | RICHARD T. DAVIS, MD PC
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Dates
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Enumeration Date | 01/09/2009
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Last Update Date | 01/09/2009
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Provider Practice Location Address
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Address Line | 1050 SW 3RD AVE SUITE 1200
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City | ONTARIO
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State | OR
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Zip | 97914-2193
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Country | US
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Telephone | 541-889-3111
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Fax | 541-889-3999
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Provider Business Mailing Address
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Address Line | 1050 SW 3RD AVE SUITE 1200
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City | ONTARIO
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State | OR
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Zip | 97914-2193
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Country | US
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Telephone | 541-889-3111
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Fax | 541-889-3999
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. RICHARD T DAVIS
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Credential | MD
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Telephone | 541-889-3111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD28858
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License Number State | OR
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