Davis, Justin R

Davis, Justin R is an individual health care provider with primary practice located at 4015 22Nd Pl , Lubbock TX 79410-1119. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Davis, Justin R can be contacted via phone (806) 725-0030.

Contact Information

Primary practice address
4015 22Nd Pl Lubbock TX 79410-1119
Phone: (806) 725-0030
Fax: (806) 725-0015
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2012004798 Missouri
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 04-35493 Kansas
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 23806 Mississippi
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X R4957 Texas

Profile Details

NPI number 1629282496
LBN Legal business name Davis, Justin R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2007
Last updated Feb 14th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629282496 NPPES
Mississippi MEDICAID 02683804

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