Provider Demographics
NPI:1669490843
Name:DAVIDSON, WILLIAM ASHTON (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ASHTON
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 W 14TH ST STE 100B
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3751
Mailing Address - Country:US
Mailing Address - Phone:812-284-1700
Mailing Address - Fax:812-284-1717
Practice Address - Street 1:302 W 14TH ST STE 100B
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3751
Practice Address - Country:US
Practice Address - Phone:812-284-1700
Practice Address - Fax:812-284-1717
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01032883A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN187130Medicare ID - Type Unspecified