Provider Demographics
NPI:1922100296
Name:DAVIS, FRANK M JR (DPM)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:M
Last Name:DAVIS
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E PLUMB LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3696
Mailing Address - Country:US
Mailing Address - Phone:775-829-8066
Mailing Address - Fax:
Practice Address - Street 1:1300 E PLUMB LN
Practice Address - Street 2:SUITE A
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3696
Practice Address - Country:US
Practice Address - Phone:775-829-8066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV49213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVT67178Medicare UPIN
NVWJBBC01Medicare PIN