Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 34921 | OK |
NPI | 1881034726 |
---|---|
Provider Name | Dr. James Philip Davies |
First Address | Tulsa, OK 74137-4212 |
Second Address | Tulsa, OK 74137-4212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2013 |
Last Update Date | 03/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05069223 | (05) | OK |
36020 | LIMITED LICENSE NUMBER (01) | SC |