Individual
HENRY S DAVIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1910 S VIRGINIA ST, SUITE 200, HOPKINSVILLE, KY 42240-3692
(270) 889-9200
(270) 889-9911
Mailing address
1910 S VIRGINIA ST, SUITE 200, HOPKINSVILLE, KY 42240-3692
(270) 889-9200
(270) 889-9911
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
KY-0293
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000211006
ANTHEM PROVIDER NUMBER
LA
01
—
1169391
CHA PROVIDER NUMBER
KY
01
—
6107168
UBH PROVIDER NUMBER
KY
01
—
7384130
AETNA PROVIDER NUMBER
KY
Enumeration date
06/07/2006
Last updated
07/08/2007
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