Provider Demographics
NPI:1053053199
Name:DAVIDSON, ARMADEUS (PA-S)
Entity Type:Individual
Prefix:
First Name:ARMADEUS
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1584 W 1370 N
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-4258
Mailing Address - Country:US
Mailing Address - Phone:360-620-3233
Mailing Address - Fax:
Practice Address - Street 1:1584 W 1370 N
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4258
Practice Address - Country:US
Practice Address - Phone:360-620-3233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-09
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant