MEDICARE: DR. ALAN C DAVIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	83-185	NM

General Provider Information

NPI Number	:	1003963539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN C DAVIS M.D.

Provider Business Mailing Address
First Line	:	3005 HILLRISE DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4703
Country	:	US
Telephone Number	:	575-521-1122
Fax Number	:	575-521-1299

Provider Business Practice Location Address
First Line	:	3005 HILLRISE DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4703
Country	:	US
Telephone Number	:	575-521-1122
Fax Number	:	575-521-1299

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	05/02/2017

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