Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 0101035144 | VA |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 010135144 | VA |
NPI | 1053310631 |
---|---|
Provider Name | Dr. Thomas C Davies |
First Address | Midlothian, VA 23112-2014 |
Second Address | Midlothian, VA 23112-2014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 18/09/2017 |