Provider Demographics
NPI:1053321158
Name:DAVIS, STUART A (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:A
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1485 N TURQUOISE DRIVE
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001
Mailing Address - Country:US
Mailing Address - Phone:928-214-3233
Mailing Address - Fax:928-226-3071
Practice Address - Street 1:1485 N TURQUOISE DR
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001
Practice Address - Country:US
Practice Address - Phone:928-774-7757
Practice Address - Fax:928-226-3071
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2016-09-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ35677207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1053321158OtherNPI
AZZ159640Medicare PIN