Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD0000055811 | TN |
Y | 208600000X | Surgeon | MD0000055811 | TN |
NPI | 1003101684 |
---|---|
Provider Name | Dr. Patrick Davis |
First Address | Columbia, TN 38401-6410 |
Second Address | Columbia, TN 38401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2011 |
Last Update Date | 14/06/2018 |