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General NPI Number Information
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NPI Number | 1891086989
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Entity Type | Individual
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Provider Name | DREW BENNETT DAVIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2011
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 1901 16TH ST STE 2
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City | BEDFORD
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State | IN
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Zip | 47421-2742
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Country | US
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Telephone | 812-279-0148
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Fax | 812-279-5155
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Provider Business Mailing Address
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Address Line | 1901 16TH ST STE 2
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City | BEDFORD
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State | IN
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Zip | 47421-2742
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Country | US
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Telephone | 812-279-0148
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Fax | 812-279-5155
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 01075373A
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License Number State | IN
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