Provider Demographics
NPI:1487817946
Name:DAVIS, JUSTIN TODD (MD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:TODD
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4000 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8501
Mailing Address - Country:US
Mailing Address - Phone:913-588-9900
Mailing Address - Fax:913-299-9542
Practice Address - Street 1:4000 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8501
Practice Address - Country:US
Practice Address - Phone:913-588-9900
Practice Address - Fax:913-299-9542
Is Sole Proprietor?:No
Enumeration Date:2008-07-05
Last Update Date:2020-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KYR1659207T00000X
KS0436378207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery