Davis, Thad J

Davis, Thad J is an sole proprietor health care provider with primary practice located at 22421 Andrew Jackson Hwy , Maxton NC 28364-6721. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Agencies / Community/Behavioral Health. Agencies / Community/Behavioral Health is his primary health care specialty. Davis, Thad J can be contacted via phone (910) 844-2008.

Contact Information

Primary practice address
22421 Andrew Jackson Hwy Maxton NC 28364-6721
Phone: (910) 844-2008
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1326173840
LBN Legal business name Davis, Thad J
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 23rd, 2007
Last updated Feb 20th, 2009 - about 16 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1326173840 NPPES
North Carolina MEDICAID 8301878

Popular Providers