Provider Demographics
NPI:1033215876
Name:MATTHEW S. DAVIS, M.D. LLC
Entity Type:Organization
Organization Name:MATTHEW S. DAVIS, M.D. LLC
Other - Org Name:DAVIS ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:SHANE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-533-6644
Mailing Address - Street 1:7191 CAHABA VALLEY RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-6402
Mailing Address - Country:US
Mailing Address - Phone:205-533-6644
Mailing Address - Fax:888-258-4852
Practice Address - Street 1:7191 CAHABA VALLEY RD
Practice Address - Street 2:SUITE 205
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-6402
Practice Address - Country:US
Practice Address - Phone:205-533-6644
Practice Address - Fax:888-258-4852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23917207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALI09369Medicare UPIN