Provider Demographics
NPI:1851158109
Name:DAVIS WHOLE FAMILY HEALTH PLLC
Entity Type:Organization
Organization Name:DAVIS WHOLE FAMILY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-233-8801
Mailing Address - Street 1:PO BOX 35662
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0634
Mailing Address - Country:US
Mailing Address - Phone:619-218-9490
Mailing Address - Fax:
Practice Address - Street 1:150 N VERDE ST STE 101
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-5257
Practice Address - Country:US
Practice Address - Phone:619-218-9490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAVIS WHOLE FAMILY HEALTH PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty