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General NPI Number Information
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NPI Number | 1811958804
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Entity Type | Individual
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Provider Name | JAMES R DAVIS DO
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Gender | Male
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 05/03/2013
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Provider Practice Location Address
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Address Line | 1101 MICHIGAN AVE
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City | LOGANSPORT
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State | IN
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Zip | 46947-1528
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Country | US
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Telephone | 574-722-2663
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 MICHIGAN AVE
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City | LOGANSPORT
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State | IN
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Zip | 46947-1528
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Country | US
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Telephone | 574-722-2663
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Fax |
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 036076015
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 02004167A
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License Number State | IN
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