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Individual

JOHN S DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5590 KIETZKE LN, RENO, NV 89511-3019
(775) 323-2080
(775) 325-2334
Mailing address
5590 KIETZKE LN, RENO, NV 89511-3019
(775) 323-2080
(775) 325-2334

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
4127
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002016378
NV
01
880167036A011
TRICARE
NV
01
CC4127
BLUE CROSS BLUE SHIELD
NV
05
XPY001350
CA
Enumeration date
06/03/2006
Last updated
03/26/2018
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