Individual
DR. MICHAEL W DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2808 FOX MEADOW LANE, JONESBORO, AR 72404-9346
(870) 335-2240
(870) 931-4457
Mailing address
2808 FOX MEADOW LANE, JONESBORO, AR 72404-9346
(870) 335-2240
(870) 931-4457
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
06-07P
AR
103TC2200X
Clinical Child & Adolescent Psychologist
06-07P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227670719
—
AR
01
—
5X989
BLUE CROSS BLUE SHIELD
AR
Enumeration date
01/16/2007
Last updated
05/10/2023
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