MEDICARE: W. ROSS DAVIS MD, PC

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	207RC0000X	Cardiovascular Disease Physician		AL

General Provider Information

NPI Number	:	1174555676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	W. ROSS DAVIS MD, PC

Provider Business Mailing Address
First Line	:	2123 EXECUTIVE PARK DR
Second Line	:
City	:	OPELIKA
State	:	AL
Zip	:	36801-6041
Country	:	US
Telephone Number	:	334-704-0307
Fax Number	:	334-704-0578

Provider Business Practice Location Address
First Line	:	2123 EXECUTIVE PARK DR
Second Line	:
City	:	OPELIKA
State	:	AL
Zip	:	36801-6041
Country	:	US
Telephone Number	:	334-704-0307
Fax Number	:	334-704-0578

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WILLIAM ROSS DAVIS
Credential	:	MD
Telephone Number	:	334-704-0307

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	06/27/2010

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