MEDICARE: DR. BRADLEY E DAVIS MD

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	208800000X	Urology Physician	0422169	KS
2	208800000X	Urology Physician	R8H42	MO

General Provider Information

NPI Number	:	1811989585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADLEY E DAVIS MD

Provider Business Mailing Address
First Line	:	10550 QUIVIRA RD
Second Line	:	STE 105
City	:	OVERLAND PARK
State	:	KS
Zip	:	66215-2306
Country	:	US
Telephone Number	:	913-438-3833
Fax Number	:	913-438-3832

Provider Business Practice Location Address
First Line	:	10550 QUIVIRA RD
Second Line	:	STE 105
City	:	OVERLAND PARK
State	:	KS
Zip	:	66215-2306
Country	:	US
Telephone Number	:	913-438-3833
Fax Number	:	913-438-3832

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	07/08/2007

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