MEDICARE: DR. DAVID A DAVIS MD FACS

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	207W00000X	Ophthalmology Physician	50609	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A07634	OTHER	CO	EYEMED INS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447246517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID A DAVIS MD FACS

Provider Business Mailing Address
First Line	:	6760 CORPORATE DR STE 180
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-5905
Country	:	US
Telephone Number	:	719-272-4227
Fax Number	:	719-632-6088

Provider Business Practice Location Address
First Line	:	6760 CORPORATE DR STE 180
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-5905
Country	:	US
Telephone Number	:	719-272-4227
Fax Number	:	719-272-3834

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	09/02/2021

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