Provider Demographics
NPI:1033240544
Name:DAVIS, BILL R (PSYD)
Entity Type:Individual
Prefix:
First Name:BILL
Middle Name:R
Last Name:DAVIS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 WINTER DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2530
Mailing Address - Country:US
Mailing Address - Phone:615-444-4300
Mailing Address - Fax:615-449-2734
Practice Address - Street 1:413 SPRING ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-3848
Practice Address - Country:US
Practice Address - Phone:423-756-2740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health