Provider Demographics
NPI:1205241171
Name:DAVIS, NATALIE (MD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S. SANTA FE AVE,
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401
Mailing Address - Country:US
Mailing Address - Phone:785-827-7996
Mailing Address - Fax:785-825-4490
Practice Address - Street 1:501 S SANTA FE AVE STE 140
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4189
Practice Address - Country:US
Practice Address - Phone:785-827-7996
Practice Address - Fax:785-825-4490
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL37176207V00000X
KS04-40886207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201207720AMedicaid