Provider Demographics
NPI:1497892772
Name:DAVIGNON, MEGHAN NORTON (MD)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:NORTON
Last Name:DAVIGNON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:JANE
Other - Last Name:NORTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:237 BUFFET CT
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-8465
Mailing Address - Country:US
Mailing Address - Phone:303-877-1574
Mailing Address - Fax:916-474-2281
Practice Address - Street 1:1600 EUREKA RD BLDG C2ND
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3027
Practice Address - Country:US
Practice Address - Phone:916-474-2977
Practice Address - Fax:916-474-2259
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO45745208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO92682511Medicaid
NM02404869Medicaid
AZ251770Medicaid
AZ251770Medicaid
8HG767Medicare PIN