Provider Demographics
NPI:1295861383
Name:JAMES L. DAVIS, M.D. P.C.
Entity Type:Organization
Organization Name:JAMES L. DAVIS, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-882-0288
Mailing Address - Street 1:P.O. BOX 60894
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20039-0894
Mailing Address - Country:US
Mailing Address - Phone:202-882-0288
Mailing Address - Fax:202-882-0285
Practice Address - Street 1:6939 GEORGIA AVE NW
Practice Address - Street 2:SUITE 103
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2456
Practice Address - Country:US
Practice Address - Phone:202-882-0288
Practice Address - Fax:202-882-0285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC10206207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC469173Medicare ID - Type Unspecified
DCD66460Medicare UPIN