Individual
ROGER W DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3676 PARKER BLVD, SUITE 230, PUEBLO, CO 81008-2212
(719) 553-2206
(719) 553-2226
Mailing address
PO BOX 9000, PUEBLO, CO 81008-9000
(719) 553-2206
(719) 553-2226
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
30919
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01309194
—
CO
01
—
1124058094
NPI
CO
Enumeration date
07/04/2006
Last updated
10/16/2013
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