Provider Demographics
NPI:1437128790
Name:DAVIDSON, DANIEL S (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
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 1:3130 E RACE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4979
Mailing Address - Country:US
Mailing Address - Phone:501-268-3232
Mailing Address - Fax:501-268-7327
Practice Address - Street 1:3130 E RACE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4979
Practice Address - Country:US
Practice Address - Phone:501-268-3232
Practice Address - Fax:501-268-7327
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC5742207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR106551001Medicaid
AR010013242Medicare PIN
ARD84138Medicare UPIN
AR106551001Medicaid
AR0904380005Medicare NSC