Individual
RICHARD W DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
911 E MAIN ST, FLOYD, VA 24091-4183
(540) 745-2031
Mailing address
1203 OLD QUAKER RD, GALAX, VA 24333-5520
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-000021
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010083923
—
VA
Enumeration date
11/17/2005
Last updated
11/09/2008
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