Provider Demographics
NPI:1003898396
Name:DAVIS, STEVEN J SR (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:DAVIS
Suffix:SR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OPP
Mailing Address - State:AL
Mailing Address - Zip Code:36467-1632
Mailing Address - Country:US
Mailing Address - Phone:334-493-3240
Mailing Address - Fax:334-493-9535
Practice Address - Street 1:802 N MAIN ST
Practice Address - Street 2:
Practice Address - City:OPP
Practice Address - State:AL
Practice Address - Zip Code:36467-1632
Practice Address - Country:US
Practice Address - Phone:334-493-3240
Practice Address - Fax:334-493-9535
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO32248207Q00000X
TXD7403207Q00000X
ALDO263207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000089191Medicaid
89191OtherBLUE CROSS