Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | A87459 | CA |
NPI | 1003887837 |
---|---|
Provider Name | Dr. Kimberly D Davis |
First Address | Portsmouth, VA 23708-2197 |
Second Address | Portsmouth, VA 23708-2197 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 15/08/2012 |