Provider Demographics
NPI:1245484765
Name:DAVIS, H. RAY (ED D)
Entity type:Individual
Prefix:MR
First Name:H.
Middle Name:RAY
Last Name:DAVIS
Suffix:
Gender:M
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7206 HULL STREET RD
Mailing Address - Street 2:STE 202
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-5827
Mailing Address - Country:US
Mailing Address - Phone:804-937-2537
Mailing Address - Fax:
Practice Address - Street 1:7206 HULL STREET RD
Practice Address - Street 2:STE 202
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-5827
Practice Address - Country:US
Practice Address - Phone:804-937-2537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1257-05-001253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1257-05-001Medicaid