Provider Demographics
NPI:1841595014
Name:J. CHRISTOPHER DAVIS, PLLC
Entity Type:Organization
Organization Name:J. CHRISTOPHER DAVIS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-988-6858
Mailing Address - Street 1:2161 VALLEYDALE RD
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-2010
Mailing Address - Country:US
Mailing Address - Phone:205-988-6858
Mailing Address - Fax:205-987-3501
Practice Address - Street 1:2161 VALLEYDALE RD
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-2010
Practice Address - Country:US
Practice Address - Phone:205-988-6858
Practice Address - Fax:205-987-3501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00025648207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051113640OtherBCBSAL
AL009962145Medicaid
AL134661Medicaid
51521978OtherBCBS
H69257Medicare UPIN
AL134661Medicaid