Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 36302 | TN |
NPI | 1013135623 |
---|---|
Provider Name | Dr. Thomas Edward Davis |
First Address | Chattanooga, TN 37404-3398 |
Second Address | Chattanooga, TN 37404-3398 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2007 |
Last Update Date | 16/12/2009 |