Provider Demographics
NPI:1326027921
Name:DAVIS, JOSEPH WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7658A MARKET ST
Mailing Address - Street 2:P.O. BOX 10300
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-9457
Mailing Address - Country:US
Mailing Address - Phone:910-686-4545
Mailing Address - Fax:910-686-0613
Practice Address - Street 1:7658A MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-9457
Practice Address - Country:US
Practice Address - Phone:910-686-4545
Practice Address - Fax:910-686-0613
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08373OtherBCBS
NC6561310-002OtherCIGNA
NC8908373Medicaid
NC260323OtherMAMSI
NC330129OtherACN
NC0829NOtherCNC
NCT-64488Medicare UPIN
NC244459Medicare ID - Type Unspecified