Provider Demographics
NPI:1255369351
Name:TSAI, DAVIS C (MD)
Entity type:Individual
Prefix:
First Name:DAVIS
Middle Name:C
Last Name:TSAI
Suffix:
Gender:M
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:PO BOX 381
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54957-0381
Mailing Address - Country:US
Mailing Address - Phone:920-223-0123
Mailing Address - Fax:920-223-0370
Practice Address - Street 1:2700 W 9TH AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-7247
Practice Address - Country:US
Practice Address - Phone:920-223-0123
Practice Address - Fax:920-223-0370
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI41077207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32577800Medicaid
WIG97654Medicare UPIN