Dr. Charles Odell Davidson
Sports Medicine Doctor Neuromusculoskeletal Medicine (NMM)
2200 Grant St
Gary
, Indiana 46404-3439
Dr. Charles Odell Davidson
Sports Medicine Doctor Neuromusculoskeletal Medicine (NMM)
2200 Grant St
Gary
, Indiana 46404-3439
(219) 864-0960
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About
Features
Specialties
- Sports Medicine Doctor
- Neuromusculoskeletal Medicine (NMM)
Languages spoken
- English
Location
First Address
- Dr. Charles Odell Davidson
- 830 Killarney Dr
- Dyer, IN
- Zip : 46311-3702
- Fax : (219) 864-0960
- Phone : (219) 864-0959
Second Address
- Dr. Charles Odell Davidson
- 2200 Grant St
- Gary, IN
- Zip : 46404-3439
- Phone : (219) 944-7565
Reviews
FAQs
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Is Dr. Charles Odell Davidson a sole practitioner?
Is Dr. Charles Odell Davidson accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 204C00000X | Sports Medicine Doctor | 01021856A | IN |
| N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 01021856A | IN |
National Provider Identifier
| NPI | 1649371568 |
|---|---|
| Provider Name | Dr. Charles Odell Davidson |
| First Address | Dyer, IN 46311-3702 |
| Second Address | Gary, IN 46404-3439 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/09/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| C250-75 | (02) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.