Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI Number | 1366702797 |
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| LBN Legal business name | PATRICK DAVIS PA-C LTD | ||||||||
| Authorized official | PATRICK DAVIS - (OWNER) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 05/18/2012 | ||||||||
| Last updated | 10/22/2019 - About 7 years ago | ||||||||
| Identifiers |
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