Provider Demographics
NPI:1689928061
Name:DAVIS, MICHAEL ARTHUR (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ARTHUR
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 SILVER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-7913
Mailing Address - Country:US
Mailing Address - Phone:928-704-7166
Mailing Address - Fax:928-704-7144
Practice Address - Street 1:2744 SILVER CREEK RD
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-7913
Practice Address - Country:US
Practice Address - Phone:928-704-7166
Practice Address - Fax:928-704-7144
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ84252086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery