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Individual

DR. THOMAS JOHN DAVIDSON IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1331 HAMILTON TER SE, ROANOKE, VA 24014-1805
(251) 747-4401
Mailing address
1331 HAMILTON TER SE, ROANOKE, VA 24014-1805
(251) 747-4401

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
SC006438
PA

Other

Enumeration date
05/21/2013
Last updated
05/21/2013
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