Provider Demographics
NPI:1649378191
Name:DAVIS, ROBERT SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SCOTT
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14209 COOK RD., SUITE 200
Mailing Address - Street 2:MEMORIAL PHYSICIAN CLINICS-ST. MARTIN NEURO & SPINE
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532
Mailing Address - Country:US
Mailing Address - Phone:228-575-2536
Mailing Address - Fax:228-872-0559
Practice Address - Street 1:14209 COOK RD., SUITE 200
Practice Address - Street 2:MEMORIAL PHYSICIAN CLINICS-ST MARTIN NEURO & SPINE
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532
Practice Address - Country:US
Practice Address - Phone:228-575-2536
Practice Address - Fax:228-872-0559
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2023-11-09
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Provider Licenses
StateLicense IDTaxonomies
MS24838207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF35292Medicare UPIN
TN3075014Medicare ID - Type Unspecified