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General NPI Number Information
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NPI Number | 1720037914
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Entity Type | Organization
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Legal Business Name | DR. JAMES O. DAVIS III O.D.P.A.
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 2615 HARRISON ST
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City | BATESVILLE
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State | AR
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Zip | 72501-7405
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Country | US
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Telephone | 870-793-4400
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Fax | 870-793-4000
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Provider Business Mailing Address
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Address Line | 2615 HARRISON ST
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City | BATESVILLE
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State | AR
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Zip | 72501-7405
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Country | US
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Telephone | 870-793-4400
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Fax | 870-793-4000
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Authorized Official
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Title or Position | DOCTOR OWNER PRESIDENT
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Name | DR. JAMES O DAVIS III
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Credential | OD OPTOMETRIC PHYSIC
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Telephone | 870-793-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | PC-102
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License Number State | AR
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