Individual
DR. BRENT RYAN DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2005009915
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10032015
BLUECROSS BLUESHIELD
IL
01
—
109208
HEALTH ALLIANCE
MO
01
—
113109
HEALTH ALLIANCE
IL
01
—
199422
BLUE CROSS BLUE SHIELD
MO
05
—
207319807
—
MO
01
—
226523
GROUP HEALTH PLAN
MO
01
—
5617586
FIRST HEALTH
MO
01
—
714579
HEALTHLINK
IL
01
—
714579
HEALTHLINK
—
01
—
753168118
UNITED HEALTHCARE
—
01
—
P00238356
RAILROAD MEDICARE
MO
01
—
P00339415
RAILROAD MEDICARE
IL
Enumeration date
03/09/2006
Last updated
01/23/2015
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