Individual
MICHAEL JAMES DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1090 N ELLINGTON PKWY, SUITE 102, LEWISBURG, TN 37091-2227
(913) 359-0019
(931) 359-7381
Mailing address
854 W JAMES CAMPBELL BLVD, SUITE 303, COLUMBIA, TN 38401-4659
(931) 359-0019
(931) 359-7381
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO781
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3130078
BLUE CROSS NUMBER
TN
05
—
3302360
—
TN
05
—
3710089
—
TN
Enumeration date
03/23/2006
Last updated
11/14/2012
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