Individual
JONATHAN L. DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3215 N. NORTH HILLS BLVD., FAYETTEVILLE, AR 72703
(479) 463-7102
(479) 463-7864
Mailing address
12 EAST APPLEBY ROAD, SUITE 102, FAYETTEVILLE, AR 72703
(479) 463-7102
(479) 463-7864
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L1828
TX
208M00000X
Hospitalist Physician
Primary
E-2690
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047338101
—
TX
Enumeration date
11/22/2005
Last updated
05/10/2017
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