Individual
DR. JOHN EVAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CLINIC DR, RICHLANDS, VA 24641-1102
(276) 964-6771
(276) 964-1314
Mailing address
PO BOX CVPA, RICHLANDS, VA 24641-1102
(276) 964-6771
(276) 964-1314
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101031673
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002744
ANTHEM BCBS
—
05
—
0107690-000
—
WV
05
—
64664568
—
KY
05
—
6785808
—
VA
Enumeration date
11/04/2005
Last updated
02/13/2015
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