Provider Demographics
NPI:1790716165
Name:DAVIS, WILLIAM ROSS (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROSS
Last Name:DAVIS
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 1:2375 CHAMPIONS BLVD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-6471
Mailing Address - Country:US
Mailing Address - Phone:334-321-3809
Mailing Address - Fax:334-321-3798
Practice Address - Street 1:2375 CHAMPIONS BLVD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-6471
Practice Address - Country:US
Practice Address - Phone:334-321-3809
Practice Address - Fax:334-321-3798
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00008835207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009911372Medicaid
AL009911384Medicaid
AL051541980OtherBCBS PROVIDER NUMBER
AL009911369Medicaid
AL009911382Medicaid
AL009911386Medicaid
AL051541981OtherBCBS PROVIDER NUMBER
AL051541983OtherBCBS PROVIDER NUMBER
AL051541974OtherBCBS PROVIDER NUMBER
AL051541982OtherBC PROVIDER NUMBER
AL1790716165OtherNPI
AL009911371Medicaid
AL009911373Medicaid
AL009911379Medicaid
AL009911380Medicaid
AL009911376Medicaid
AL009911383Medicaid
AL051541979OtherBCBS PROVIDER NUMBER
AL009911376Medicaid
AL009911371Medicaid