Individual
DAVID DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1001 TOWSON AVE, FORT SMITH, AR 72901-4921
(903) 663-3600
(903) 663-3629
Mailing address
PO BOX 1712, LONGVIEW, TX 75606-1712
(903) 663-3600
(903) 663-3629
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
L42259
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L42259
RN LICENSE
AR
Enumeration date
08/16/2011
Last updated
08/16/2011
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