Provider Demographics
NPI:1942203963
Name:DAVIS, STACY FAITH (MD)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:FAITH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:501 GREAT CIRCLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1317
Mailing Address - Country:US
Mailing Address - Phone:615-329-5144
Mailing Address - Fax:615-284-2595
Practice Address - Street 1:222 2ND AVE N
Practice Address - Street 2:STE 400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37201-1646
Practice Address - Country:US
Practice Address - Phone:615-329-5144
Practice Address - Fax:615-284-2595
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2017-10-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN27614207RC0000X, 207RA0001X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6012044OtherBCBS
TN3097373Medicaid
TNP01376946OtherRR MEDICARE
TN1510069Medicaid
TN3097373Medicaid
TN1510069Medicaid
TN1510069Medicaid