Provider Demographics
NPI:1518995299
Name:DAVIS, JAMES ALVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALVIN
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8126
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-7603
Mailing Address - Fax:314-747-5213
Practice Address - Street 1:10 BARNES WEST DR
Practice Address - Street 2:DIV IM NEPHROLOGY, STE 200
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6287
Practice Address - Country:US
Practice Address - Phone:314-362-7603
Practice Address - Fax:314-747-5213
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2021-11-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2017033773207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200059782Medicaid
OHP00229288OtherMEDICARE RAILROAD
KYP00360796OtherMEDICARE RAILROAD
KY64110299Medicaid
KYP00360796OtherMEDICARE RAILROAD
OH2534350Medicaid
OH4151261Medicare PIN