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Individual

JAMES V DAVIDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA CCCA

Contact information

Practice address
530 W FAULKNER, EL DORADO, AR 71730
(870) 862-5339
(870) 862-7571
Mailing address
530 W FAULKNER, EL DORADO, AR 71730
(870) 862-5339
(870) 862-7571

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
42
AR
237600000X
Audiologist-Hearing Aid Fitter
229
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106174720
AR
01
114404720
MCAID PAY TO
AR
Enumeration date
09/15/2006
Last updated
06/08/2016
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