Provider Demographics
NPI:1245765767
Name:DAVIDSON, WHITNEY AUSTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:AUSTIN
Last Name:DAVIDSON
Suffix:
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 1:1001 S HORSEBARN RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8184
Mailing Address - Country:US
Mailing Address - Phone:479-273-7700
Mailing Address - Fax:479-464-7734
Practice Address - Street 1:1001 S HORSEBARN RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8184
Practice Address - Country:US
Practice Address - Phone:479-273-7700
Practice Address - Fax:479-464-7734
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ARE-15535208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program