Provider Demographics
NPI:1356571392
Name:DAVIDSON, KEVIN ROSS (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:ROSS
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:12700 EAST 19TH AVENUE
Mailing Address - Street 2:RM 9023 MAIL STOP C272
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045
Mailing Address - Country:US
Mailing Address - Phone:303-724-6043
Mailing Address - Fax:303-724-6042
Practice Address - Street 1:12700 EAST 19TH AVENUE, RM 9023 MAIL STOP C272
Practice Address - Street 2:PULMONARY SCIENCES AND CRITICAL CARE MEDICINE
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:303-724-6043
Practice Address - Fax:303-724-6042
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2016-07-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN9691207R00000X
NC2012-02395207R00000X
COTL0005814207RP1001X
CODR.0057093207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine