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NPI Code Detail

MEDICARE: TIFFANY DAVIDSON

MEDICARE:   TIFFANY  DAVIDSON
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
1235Z00000XSpeech-Language PathologistS-4901MS

General Provider Information

NPI Number : 1740129444
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY DAVIDSON
Provider Business Mailing Address
First Line : 137 BLASINGAME DR
Second Line :
City : COLUMBUS
State : MS
Zip : 39702-7120
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1411 HIGHWAY 389
Second Line :
City : STARKVILLE
State : MS
Zip : 39759-8451
Country : US
Telephone Number : 662-769-4888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2026
Last Update Date : 03/26/2026

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Directions to “ TIFFANY DAVIDSON ” Practice Location

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