Provider Demographics
NPI:1154071868
Name:DAVIS, JOSEPH F III
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:F
Last Name:DAVIS
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 ESTONIA DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-9019
Mailing Address - Country:US
Mailing Address - Phone:859-893-2842
Mailing Address - Fax:
Practice Address - Street 1:3050 RIO DOSA DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1540
Practice Address - Country:US
Practice Address - Phone:859-269-2325
Practice Address - Fax:859-268-6473
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY269843101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)