Physician Compare National (NPI:1265422703)
HEALTHCARE PROVIDER: ROSALIE DAVIS PHD, RXP
Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.
Individual Professional Information |
|
NPI
|
1265422703
|
|
Unique healthcare provider (clinician) ID assigned by NPPES
|
|
PECOS UID
|
0446430029
|
|
Unique individual clinician ID assigned by PECOS
|
|
Professional Enrollment ID
|
I20110215000200
|
|
Unique ID for the individual professional enrollment that is the source for the data in the observation
|
|
Provider Last Name
|
DAVIS
|
|
Individual professional last name
|
|
Provider First Name
|
ROSALIE
|
|
Individual professional first name
|
|
Provider Gender
|
F
|
|
The provider's gender if the provider is a person.
|
Medical School Information |
|
Medical School Name
|
UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
|
|
Individual professional's medical school
|
|
Graduation Year
|
1972
|
|
Individual professional's medical school graduation year
|
|
Primary Specialty
|
PSYCHOLOGIST, CLINICAL
|
|
Primary medical specialty reported by the individual professional in the selected enrollment
|
Practice Information |
|
Line 1 Street Address
|
3003 LOUISANA BLVD NE
|
|
Group Practice or individual's line 1 address
|
|
City
|
ALBUQUERQUE
|
|
Group Practice or individual's city
|
|
State
|
NM
|
|
Group Practice or individual's state
|
|
Zip Code
|
871102734
|
|
Group Practice or individual's zip code (9 digits when available)
|
|
Phone Number
|
5058810404
|
|
Phone number is listed only when there is a single phone number available for the practice location address
|
Hospital(s) Affiliation Information |
|
Professional Accepts Medicare Assignment
|
Y
|
|
|