MEDICARE: EVELYNE MONIQUE DAVIDSON MD

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	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	020655	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	110221350	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100022381	OTHER	TN	PHP TNCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	4007807	OTHER	TN	BLUE CROSS
7	602002790	OTHER	TN	CARITEN

General Provider Information

NPI Number	:	1083724017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVELYNE MONIQUE DAVIDSON MD

Provider Business Mailing Address
First Line	:	4611 HOLSTON HILLS RD
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37914-5007
Country	:	US
Telephone Number	:	865-523-8987
Fax Number	:	865-637-1835

Provider Business Practice Location Address
First Line	:	4611 HOLSTON HILLS RD
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37914-5007
Country	:	US
Telephone Number	:	865-523-8987
Fax Number	:	865-637-1835

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	06/07/2026

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