Individual
KENT W. DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3869 CANTERBURY WAY, IDAHO FALLS, ID 83404-7971
(208) 523-1652
Mailing address
3869 CANTERBURY WAY, IDAHO FALLS, ID 83404-7971
(208) 523-1652
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
M-5823
ID
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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