Provider Demographics
NPI:1457391690
Name:DAVIS, JAMES E (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3705 MIDWAY DR
Mailing Address - Street 2:
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-1456
Mailing Address - Country:US
Mailing Address - Phone:541-523-6428
Mailing Address - Fax:541-523-4713
Practice Address - Street 1:3705 MIDWAY DR
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-1456
Practice Address - Country:US
Practice Address - Phone:541-523-6428
Practice Address - Fax:541-523-4713
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD12060207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR119172Medicaid
ORC92482Medicare UPIN
OR119172Medicaid