Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | E-10206 | AR |
N | 208000000X | Pediatrician | E-10206 | AR |
NPI | 1033452990 |
---|---|
Provider Name | Dr. Kevin Allen Davis |
First Address | Little Rock, AR 72205-7101 |
Second Address | Fort Smith, AR 72903-4100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2013 |
Last Update Date | 03/07/2019 |