Individual
DR. JAMES R DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1101 MICHIGAN AVE, LOGANSPORT, IN 46947-1528
(574) 722-2663
Mailing address
1101 MICHIGAN AVE, LOGANSPORT, IN 46947-1528
(574) 722-2663
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
02004167A
IN
207X00000X
Orthopaedic Surgery Physician
036076015
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000808791
ANTHEM
IN
05
—
036076015
—
IL
01
—
200019369
COMMERCIAL
IL
01
—
3160469577
BCBS
IL
Enumeration date
03/29/2006
Last updated
05/03/2013
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