Provider Demographics
NPI:1891965232
Name:DR JEFFREY PHILLIPS DAVIES
Entity Type:Organization
Organization Name:DR JEFFREY PHILLIPS DAVIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:PHILLIPS
Authorized Official - Last Name:DAVIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-385-0890
Mailing Address - Street 1:900 ROUTE 134
Mailing Address - Street 2:B;DG 1
Mailing Address - City:SOUTH DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02660-2575
Mailing Address - Country:US
Mailing Address - Phone:508-385-0890
Mailing Address - Fax:
Practice Address - Street 1:900 ROUTE 134
Practice Address - Street 2:B;DG 1
Practice Address - City:SOUTH DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02660-2575
Practice Address - Country:US
Practice Address - Phone:508-385-0890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5175530001Medicare NSC