Individual
DR. RANDEL C DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(602) 249-0212
Mailing address
15623 S 16TH ST, PHOENIX, AZ 85048-8632
(480) 460-4525
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2484
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078817
—
AZ
01
—
3981220
EVERCARE - GROUP #
AZ
01
—
453051001
GROUP HEALTH - GROUP #
AZ
01
—
860373636
HUMANA - GROUP #
AZ
01
—
AW1436
HEALTHNET - GROUP #
AZ
01
—
AZ0728670
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
11/22/2005
Last updated
11/27/2018
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