Provider Demographics
NPI:1528031168
Name:DAVY, JAMES MARION (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MARION
Last Name:DAVY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2623
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57709-2623
Mailing Address - Country:US
Mailing Address - Phone:605-341-7854
Mailing Address - Fax:605-867-3263
Practice Address - Street 1:PINE RIDGE IHS HOSPITAL, E HWY 18
Practice Address - Street 2:
Practice Address - City:PINE RIDGE
Practice Address - State:SD
Practice Address - Zip Code:57770-1201
Practice Address - Country:US
Practice Address - Phone:605-867-3067
Practice Address - Fax:605-867-3263
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO22242207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine