Davis, Mark L

Davis, Mark L is an sole proprietor health care provider with primary practice located at 1739 E Beverly Ave Ste 102 , Kingman AZ 86409-3593. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Davis, Mark L can be contacted via phone (928) 681-8693.

Contact Information

Primary practice address
1739 E Beverly Ave Ste 102 Kingman AZ 86409-3593
Phone: (928) 681-8693
Fax: (928) 681-8694
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 5101012747 Michigan
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 007480 Arizona

Profile Details

NPI number 1083618615
LBN Legal business name Davis, Mark L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 10th, 2005
Last updated Apr 11th, 2022 - about 4 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 1083618615 NPPES
Michigan Other 200C313650 BCBS MI
Michigan MEDICAID 4837808 BCBS MI
Michigan Other 200C31650 BCBS MI
Michigan Other 300040412 BCBS MI
Michigan Other 200000001852 BCBS MI
Michigan Other 2053302675 BCBS MI

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