Individual
PHILLIP S DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
ONE HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-2568
(573) 882-2226
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
076916
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127254
BLUE SHIELD/BLUE CHOICE
MO
01
—
180595
HEALTHLINK
MO
01
—
2001341
UNITED HEALTHCARE
MO
Enumeration date
05/30/2006
Last updated
12/27/2007
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