Individual
JOHN A DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1380 E MEDICAL CENTER DR, ST GEORGE, UT 84790-2123
(435) 251-1700
Mailing address
283 E 930 S, OREM, UT 84058-5001
(801) 225-6246
(801) 225-1525
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
018094
LA
2085R0202X
Diagnostic Radiology Physician
Primary
180687-1205
UT
2085R0202X
Diagnostic Radiology Physician
9258
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107005493101
IHC
UT
01
—
300080588
R/R MEDICARE
UT
01
—
681072
DMBA #
UT
05
—
870487570004
—
UT
01
—
870487570DA1
EMIA #
UT
Enumeration date
05/23/2006
Last updated
05/09/2019
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