| Doctor Name: | KEVIN DAVIS |
| NPI Number: | 1811903529 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA244 |
| Business Practice Address: | 70 Holly Hills Mall Rd Hindman, KY - 418229121 |
| Business Phone Number: | 6067859440 |
| Business Fax Number: | 6067859645 |
| Mailing Address: | 70 Holly Hills Mall Rd, HINDMAN |
| State: | KY |
| Postal Code: | 418229121 |
| Phone Number: | 6067859440 |
| Fax Number: | 6067859645 |
| NPI Enumeration Date: | 08/01/2006 |
| NPI Last Update Date: | 04/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA244 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |