Davis, Raymond A.

Davis, Raymond A. is an individual health care provider with primary practice located at 2300 N Rockton Ave , Rockford IL 61103-3619. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Davis, Raymond A. can be contacted via phone (815) 971-2000.

Contact Information

Primary practice address
2300 N Rockton Ave Rockford IL 61103-3619
Phone: (815) 971-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036-073340 Illinois

Profile Details

NPI number 1417067604
LBN Legal business name Davis, Raymond A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jan 29th, 2010 - about 15 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 1417067604 NPPES
Illinois MEDICAID 036073340

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