Individual
DR. R KEITH DAVIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
E3055
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145479001
—
AR
01
—
5M036
BCBS
AR
01
—
A002
TRICARE
AR
Enumeration date
07/29/2005
Last updated
02/21/2013
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