Provider Demographics
NPI:1861638538
Name:DAVIDSON, JOEL R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:R
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:ONE PERKINS SQUARE
Mailing Address - Street 2:LOCUST PEDIATRIC CARE GROUP, LOCUST SUITE 390
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308
Mailing Address - Country:US
Mailing Address - Phone:330-543-8530
Mailing Address - Fax:330-543-3731
Practice Address - Street 1:ONE PERKINS SQ.
Practice Address - Street 2:LOCUST PEDIATRIC CARE GROUP, AKRON CHILDREN'S HOSPITAL
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1062
Practice Address - Country:US
Practice Address - Phone:330-543-8530
Practice Address - Fax:330-543-3731
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH57.014961208000000X
OH35.096888208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics