Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 00520 | CO |
NPI | 1003898685 |
---|---|
Provider Name | James D Davis |
First Address | Thornton, CO 80229-4358 |
Second Address | Thornton, CO 80229-4358 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 28/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
88402045 | (05) | CO |
U73994 | (02) | CO |