Individual
ROGER A DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1220 CHATBURN AVE, HARLAN, IA 51537-2009
(712) 755-5130
(712) 755-4470
Mailing address
1213 GARFIELD AVE, HARLAN, IA 51537-2057
(712) 755-5161
(712) 755-4312
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22994
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1197392
—
IA
Enumeration date
08/23/2006
Last updated
08/31/2007
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