MEDICARE: DR. BARNEY MCCOY DAVIS JR. 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	2084P0800X	Psychiatry Physician	23658	SC

General Provider Information

NPI Number	:	1477552909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARNEY MCCOY DAVIS JR. M.D.

Provider Business Mailing Address
First Line	:	PO BOX 42958
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85080-2958
Country	:	US
Telephone Number	:	803-240-4704
Fax Number	:

Provider Business Practice Location Address
First Line	:	3329 W DANBURY DR
Second Line	:	F110
City	:	PHOENIX
State	:	AZ
Zip	:	85053-1810
Country	:	US
Telephone Number	:	803-240-4704
Fax Number	:

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	01/08/2015

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