Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 30736 | CO |
NPI | 1043266794 |
---|---|
Provider Name | Kevin P Davis |
First Address | Englewood, CO 80113-2736 |
Second Address | Englewood, CO 80113-2736 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000107100 | (05) | MT |
01307362 | (05) | CO |
104671300 | (05) | WY |
84142397300 | (05) | NE |