Provider Demographics
NPI:1164483392
Name:DAVIS, STANTON B JR (MD)
Entity Type:Individual
Prefix:DR
First Name:STANTON
Middle Name:B
Last Name:DAVIS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-539-2728
Mailing Address - Fax:256-428-3423
Practice Address - Street 1:927 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-539-2728
Practice Address - Fax:256-428-3423
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21655207X00000X
TN31085207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51502574OtherBCBS
AL7327027OtherAETNA
AL0900180OtherUNITED HEALTHCARE
AL200042221OtherRAILROAD MEDICARE
AL051502574Medicaid
AL200042221OtherRAILROAD MEDICARE
AL7327027OtherAETNA
AL51502574OtherBCBS