Provider Demographics
NPI:1649235656
Name:DAVIS, JOSEPH FREDERICK (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FREDERICK
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1230B CLARK ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-9807
Practice Address - Country:US
Practice Address - Phone:740-439-3338
Practice Address - Fax:740-439-8760
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003415213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH36003415OtherLICENSE
OH2599068Medicaid
OHV05884Medicare UPIN
OH2599068Medicaid
OH36003415OtherLICENSE