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Individual

DR. RICHARD PERRY DAVIS

Active
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Individual

DR. RICHARD PERRY DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.054799
IL
2085R0202X
Diagnostic Radiology Physician
Primary
ME120255
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036.1275555
STATE OF ILLINOIS, DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
01
125.054799
TEMPORARY MEDICAL LICENSE
IL
Enumeration date
04/20/2009
Last updated
06/27/2014
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