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Organization
RICHARD K DAVIS MD PLLC PA
Active
Organization
RICHARD K DAVIS MD PLLC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD K DAVIS SR. M.D. (SOLE MEMBER)
(870) 725-3471
Entity
Organization
Contact information
Practice address
1400 PERSHING HWY, SMACKOVER, AR 71762-2300
(870) 725-3471
(870) 725-3215
Mailing address
PO BOX 69, SMACKOVER, AR 71762-0069
(870) 725-3471
(870) 725-3215
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C6398
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106187001
—
AR
01
—
51303
BCBS
—
Enumeration date
09/16/2009
Last updated
09/23/2009
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