Provider Demographics
NPI:1780005629
Name:JOHN W DAVIS, PH.D.
Entity Type:Organization
Organization Name:JOHN W DAVIS, PH.D.
Other - Org Name:BAY AREA PSYCHOLOGY & COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE AND BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AJ
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-343-0566
Mailing Address - Street 1:273 AZALEA RD
Mailing Address - Street 2:SUITE 2-413
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-1970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:273 AZALEA RD
Practice Address - Street 2:SUITE 2-413
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-1970
Practice Address - Country:US
Practice Address - Phone:251-343-0566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALR55617Medicare UPIN