Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | BP10056453 | TX |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | DR.0065919 | CO |
NPI | 1124473194 |
---|---|
Provider Name | Brian Patrick Davis |
First Address | Aurora, CO 80042-0429 |
Second Address | Englewood, CO 80112-5069 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2016 |
Last Update Date | 15/07/2021 |