Provider Demographics
NPI:1003963539
Name:DAVIS, ALAN C (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:C
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3005 HILLRISE DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4703
Mailing Address - Country:US
Mailing Address - Phone:575-521-1122
Mailing Address - Fax:575-521-1299
Practice Address - Street 1:3005 HILLRISE DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4703
Practice Address - Country:US
Practice Address - Phone:575-521-1122
Practice Address - Fax:575-521-1299
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM83-185207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM00162Medicare PIN
NM2134174Medicare PIN