Organization
DAVIS FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SABRINA L DAVIS DO (OWNER)
(419) 756-7500
Entity
Organization
Contact information
Practice address
390 MARION AVE, MANSFIELD, OH 44903-2015
(419) 756-7500
(419) 525-0001
Mailing address
390 MARION AVE, MANSFIELD, OH 44903-2015
(419) 756-7500
(419) 525-0001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000213452
BLUE SHIELD
OH
05
—
2018613
—
OH
01
—
340069404001
MEDICAL MUTUAL
OH
01
—
5240682
AETNA
OH
01
—
57229940400
BWC
OH
Enumeration date
11/16/2006
Last updated
01/20/2012
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