Individual
DR. CHARLES REESE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4252 S HIGHLAND DR STE 200, HOLLADAY, UT 84124-2690
(801) 965-3600
Mailing address
PO BOX 70629, SALT LAKE CITY, UT 84170-0629
(801) 965-3600
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
241883
NY
208600000X
Surgery Physician
Primary
6463025-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265638357
—
UT
Enumeration date
10/11/2006
Last updated
09/25/2023
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