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Individual

STANLEY EDGAR DAVIES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
5 E 5TH ST, SUITE 212, FULTON, MO 65251-1755
(573) 642-2294
Mailing address
5 E 5TH ST, SUITE 212, FULTON, MO 65251-1755
(573) 642-2294

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000367
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300749702
MO
05
300749710
MO
Enumeration date
07/13/2006
Last updated
07/09/2007
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