Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD20753 | ME |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 32290 | KY |
NPI | 1144394099 |
---|---|
Provider Name | Dr. Jeffrey Neil Davila |
First Address | Lewiston, ME 04243-7291 |
Second Address | Auburn, ME 04210-6347 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 17/08/2020 |