Individual
DR. KEVIN W DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
312 NORTHCREST DR, SPRINGFIELD, TN 37172-3963
(615) 384-3112
(615) 382-7332
Mailing address
PO BOX 1455, SPRINGFIELD, TN 37172-1455
(615) 382-8056
(615) 382-8056
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00302
KY
213ES0131X
Foot Surgery Podiatrist
302
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3353857
—
TN
05
—
3736461
—
TN
01
—
4179406
BLUE CROSS BLUE SHIELD TENNESSEE
—
05
—
80000565
—
KY
05
—
80900319
—
KY
01
—
90004391
MEDICAID DME
KY
01
—
DF9516
RAILROAD MEDICARE
KY
01
—
P00419400
RAILROAD MEDICARE
KY
Enumeration date
07/14/2005
Last updated
07/10/2008
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