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Individual

MR. KENNETH JOHN DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
101 S FAIRFAX ST, DENVER, CO 80246-3135
(303) 993-2629
(303) 993-2934
Mailing address
101 S FAIRFAX ST, DENVER, CO 80246-3135
(303) 993-2629
(303) 993-2934

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1755
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
49583735
CO
Enumeration date
03/06/2007
Last updated
02/28/2022
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