Individual
DR. JUSTIN MARK DAVIS
Active
Individual
DR. JUSTIN MARK DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
27437
OK
207L00000X
Anesthesiology Physician
Primary
BP1-0026250
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200286500A
—
OK
01
—
3849060601
MYUTMB 3849060601-COMMERCIAL NUMBER
—
Enumeration date
06/14/2007
Last updated
01/30/2014
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