Doctor Name: | DR. RANDALL B DAVIS |
NPI Number: | 1265435697 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | R3860 |
Business Practice Address: | 2145 N Kantz Ln Fayetteville, AR - 727033165 |
Business Phone Number: | 4797996303 |
Business Fax Number: | |
Mailing Address: | Po Box 8069, FAYETTEVILLE |
State: | AR |
Postal Code: | 727030001 |
Phone Number: | 4797996303 |
Fax Number: | |
NPI Enumeration Date: | 05/31/2005 |
NPI Last Update Date: | 09/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | R3860 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |