| Doctor Name: | MR. FREDERICK LENDEL DAVIDSON |
| NPI Number: | 1336194232 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | RN115554 |
| Business Practice Address: | 17 Little Big Horn St Fort Irwin, CA - 923101776 |
| Business Phone Number: | 7603805327 |
| Business Fax Number: | 7603805861 |
| Mailing Address: | 17 Little Big Horn St, FORT IRWIN |
| State: | CA |
| Postal Code: | 923101776 |
| Phone Number: | 7603805327 |
| Fax Number: | 7603805861 |
| NPI Enumeration Date: | 05/23/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | RN115554 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |