Individual
DR. PAUL WAYNE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7400 DOLLARWAY RD, STE A, WHITE HALL, AR 71602-3025
(870) 879-6791
(870) 879-4476
Mailing address
PO BOX 20940, WHITE HALL, AR 71612-0940
(870) 879-6791
(870) 879-4476
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C6162
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103077001
—
AR
01
—
110066191
MEDICARE-ID UNSPECIFIED
—
Enumeration date
08/25/2005
Last updated
02/26/2020
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