Individual
NEVILLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2511 W EDGEWOOD DR, STE D, JEFFERSON CITY, MO 65109-5869
(573) 761-2121
(573) 635-0726
Mailing address
PO BOX 1027, JEFFERSON CITY, MO 65102-1027
(573) 761-7246
(573) 761-6947
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R4P82
MO
207Q00000X
Family Medicine Physician
Primary
R4P82
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102869
HEALTHLINK
MO
01
—
104984
UNITED HEALTHCARE
MO
05
—
205754807
—
MO
05
—
205958408
—
MO
01
—
2086335801
KANSAS MEDICAID
MO
01
—
40006670
RR MEDICARE
MO
Enumeration date
06/01/2006
Last updated
09/28/2012
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