Provider Demographics
NPI:1275556599
Name:DAVILA, DAVID G (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:DAVILA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11001 EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4316
Mailing Address - Country:US
Mailing Address - Phone:501-202-1902
Mailing Address - Fax:501-202-1512
Practice Address - Street 1:9500 KANIS RD
Practice Address - Street 2:HICKINGBOTHAM OUTPATIENT CENTER
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6324
Practice Address - Country:US
Practice Address - Phone:501-202-1902
Practice Address - Fax:501-202-1512
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2008-05-15
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Provider Licenses
StateLicense IDTaxonomies
ARE0022207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1275556599OtherMUNICIPAL HEALTH
19675000040OtherQUAL CHOICE
2075612OtherUNITED HEALTHCARE
5593044OtherAETNA
71-0781138OtherAMCO
71-0781138OtherGREAT WEST
F002OtherTRICARE
AR126828801Medicaid
510810OtherHEALTHLINK
5J356OtherBCBS
2738596OtherCIGNA
710781138028OtherTRICARE
SPE 0022OtherARKANSAS COMMUNITY CARE
510810OtherHEALTHLINK
71-0781138OtherAMCO
5J356OtherBCBS
5J356Medicare PIN