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Individual

MR. THOMAS JAY DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3873 N PARKVIEW DR, PHYSICIANS' SPECIALTY HOSPITAL, FAYETTEVILLE, AR 72703
(479) 571-7070
(479) 571-7090
Mailing address
3873 N. PARKVIEW DR, PHYSICIANS' SPECIALTY HOSPITAL, FAYETTEVILLE, AR 72703
(479) 571-7070
(479) 571-7090

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C8249
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100072550A
OK
05
131063001
AR
01
770119401
ARKANSAS BREASTCARE
AR
Enumeration date
12/05/2005
Last updated
05/20/2014
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