Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 5101015452 | MI |
N | 207PE0004X | Emergency Medical Services | 20A 9988 | CA |
NPI | 1013928589 |
---|---|
Provider Name | Dr. Jeffery W. Davies |
First Address | Palm Springs, CA 92262-4872 |
Second Address | Palm Springs, CA 92262-4872 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 23/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4832187 | (05) | MI |
I07125 | (02) | MI |