Provider Demographics
NPI:1043266794
Name:DAVIS, KEVIN P (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:P
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2736
Mailing Address - Country:US
Mailing Address - Phone:303-781-9090
Mailing Address - Fax:303-781-8710
Practice Address - Street 1:701 E HAMPDEN AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2736
Practice Address - Country:US
Practice Address - Phone:303-781-9090
Practice Address - Fax:303-781-8710
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO30736207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY104671300Medicaid
MT0000107100Medicaid
CO01307362Medicaid
NE84142397300Medicaid
WY104671300Medicaid