Davis, Michael W

Davis, Michael W is an individual health care provider with primary practice located at 2808 Fox Meadow Lane , Jonesboro AR 72404-9346. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Davis, Michael W can be contacted via phone (870) 335-2240.

Contact Information

Primary practice address
2808 Fox Meadow Lane Jonesboro AR 72404-9346
Phone: (870) 335-2240
Fax: (870) 931-4457
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 06-07P Arkansas
Behavioral Health & Social Service Providers / Clinical 103TC0700X 06-07P Arkansas

Profile Details

NPI number 1588715486
LBN Legal business name Davis, Michael W
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated May 10th, 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 1588715486 NPPES
Arkansas Other 5X989 BLUE CROSS BLUE SHIELD
Arkansas MEDICAID 227670719 BLUE CROSS BLUE SHIELD

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