Organization
ASHLEY A DAVIS M.D.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY A DAVIS MD (PRESIDENT)
(208) 429-9100
Entity
Organization
Contact information
Practice address
222 N 2ND ST, SUITE 204, BOISE, ID 83702-6109
(208) 429-9100
(208) 429-9118
Mailing address
PO BOX 44613, BOISE, ID 83711-0613
(208) 429-9100
(208) 429-9118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010151197
REGENCE BLUE SHIELD OF ID
ID
01
—
8L097
BLUE CROSS OF IDAHO
ID
Enumeration date
03/15/2007
Last updated
08/22/2020
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