Davis, Thomas Vance

Davis, Thomas Vance is an individual health care provider with primary practice located at 1151 Hospital Way Bldg A , Pocatello ID 83201-2763. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Davis, Thomas Vance can be contacted via phone (208) 232-6616.

Contact Information

Primary practice address
1151 Hospital Way Bldg A Pocatello ID 83201-2763
Phone: (208) 232-6616
Fax: (208) 232-6618
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 0-173 Idaho
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 10165949-8904 Utah

Profile Details

NPI number 1295757433
LBN Legal business name Davis, Thomas Vance
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2006
Last updated Jan 27th, 2017 - about 8 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 1295757433 NPPES
Idaho MEDICAID 002803100

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