Provider Demographics
NPI:1003025875
Name:DAVOL, PATRICK ERIN (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:ERIN
Last Name:DAVOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1698 E MCANDREWS RD STE 280
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-5590
Mailing Address - Country:US
Mailing Address - Phone:541-774-5808
Mailing Address - Fax:541-732-3910
Practice Address - Street 1:1698 E MCANDREWS RD STE 280
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-5590
Practice Address - Country:US
Practice Address - Phone:541-774-5808
Practice Address - Fax:541-732-3910
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD152128208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology