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General NPI Number Information
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NPI Number | 1760488571
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Entity Type | Individual
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Provider Name | BRIAN W DAVIS PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/27/2005
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Last Update Date | 03/25/2014
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Provider Practice Location Address
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Address Line | 360 PEAK ONE DRIVE STE 180
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City | FRISCO
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State | CO
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Zip | 80443
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Country | US
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Telephone | 970-668-3633
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Fax | 970-668-4406
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Provider Business Mailing Address
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Address Line | PO BOX 1921
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City | ENGLEWOOD
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State | CO
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Zip | 80150-1921
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Country | US
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Telephone | 970-241-0202
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Fax | 970-245-0250
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 841
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License Number State | CO
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