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NPI Code Detail

MEDICARE: BENNET E DAVIS MD

MEDICARE: BENNET 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
1207LP2900XPain Medicine (Anesthesiology) Physician23871AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902893399
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENNET E DAVIS MD
Provider Business Mailing Address
First Line : 2455 E MIRAVAL PRIMERO
Second Line :
City : TUCSON
State : AZ
Zip : 85718-3035
Country : US
Telephone Number : 520-591-3760
Fax Number :
Provider Business Practice Location Address
First Line : 39580 S LAGO DEL ORO PKWY
Second Line :
City : TUCSON
State : AZ
Zip : 85739-1091
Country : US
Telephone Number : 520-591-3760
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 09/13/2019

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Directions to “ BENNET E DAVIS MD” Practice Location

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