Provider Demographics
NPI:1437156205
Name:DAVIS, FRANK S (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:S
Last Name:DAVIS
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 1:5861 N ORACLE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-3813
Mailing Address - Country:US
Mailing Address - Phone:520-293-6686
Mailing Address - Fax:520-887-1736
Practice Address - Street 1:5861 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-3813
Practice Address - Country:US
Practice Address - Phone:520-293-6686
Practice Address - Fax:520-887-1736
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36401208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256834900Medicaid
AZ164587Medicaid
FLB78345Medicare UPIN
FL449856Medicare ID - Type Unspecified