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NPI Code Detail

MEDICARE: MR. EDWARD H DAVIS OD

MEDICARE:  MR. EDWARD H 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
1152W00000XOptometristTUV004835NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1100159CSOTHERNYHMO PREFERRED CARE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3NY4835OTHEREYEMED
4122288OTHERNYCOLE MANAGED CARE PROVIDE

General Provider Information

NPI Number : 1811970445
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDWARD H DAVIS OD
Provider Business Mailing Address
First Line : 403 EAST ST
Second Line :
City : PITTSFORD
State : NY
Zip : 14534-3644
Country : US
Telephone Number : 585-387-9971
Fax Number :
Provider Business Practice Location Address
First Line : 6081 RTE 96 S
Second Line :
City : FARMINGTON
State : NY
Zip : 14425
Country : US
Telephone Number : 585-924-2550
Fax Number : 585-924-4399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 07/08/2007

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Directions to “ MR. EDWARD H DAVIS OD” Practice Location

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