Provider Demographics
NPI:1093712721
Name:DAVIS, THOMAS L III (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:L
Last Name:DAVIS
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3116 N STOCKTON HILL RD
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-4183
Mailing Address - Country:US
Mailing Address - Phone:928-753-3443
Mailing Address - Fax:928-753-4395
Practice Address - Street 1:3116 N STOCKTON HILL RD
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-4183
Practice Address - Country:US
Practice Address - Phone:928-753-3443
Practice Address - Fax:928-753-4395
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ1743207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology