MEDICARE: DR. LINDA C DAVIS OD

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	152W00000X	Optometrist	1025	NV

General Provider Information

NPI Number	:	1477113207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA C DAVIS OD

Provider Business Mailing Address
First Line	:	4840 E BONANZA RD STE 6
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-3453
Country	:	US
Telephone Number	:	702-385-7331
Fax Number	:	702-385-5431

Provider Business Practice Location Address
First Line	:	4840 E BONANZA RD STE 6
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-3453
Country	:	US
Telephone Number	:	702-385-7331
Fax Number	:	702-385-5431

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

Provider Enumeration Date	:	06/14/2019
Last Update Date	:	06/14/2019

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Directions to “ DR. LINDA C DAVIS OD” Practice Location

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