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General NPI Number Information
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NPI Number | 1659389278
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Entity Type | Organization
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Legal Business Name | LEE A. DAVIS, JR, MD, PA
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 7500 DOLLARWAY RD STE 301
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City | WHITE HALL
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State | AR
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Zip | 71602-3084
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Country | US
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Telephone | 870-850-0800
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Fax | 870-850-0801
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Provider Business Mailing Address
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Address Line | 7500 DOLLARWAY RD STE 301
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City | WHITE HALL
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State | AR
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Zip | 71602-3084
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Country | US
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Telephone | 870-850-0800
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Fax | 870-850-0801
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEE ANDREW DAVIS JR.
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Credential | M.D.
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Telephone | 870-850-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | E2239
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License Number State | AR
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