Provider Demographics
NPI:1780003624
Name:DAVILA, WILLIAM A (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:DAVILA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2 SHIRCLIFF WAY
Mailing Address - Street 2:SUITE 700 DEPAUL BLDG
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204
Mailing Address - Country:US
Mailing Address - Phone:904-389-5333
Mailing Address - Fax:904-389-5332
Practice Address - Street 1:13241 BARTRAM PARK BLVD
Practice Address - Street 2:SUITE 1509
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258
Practice Address - Country:US
Practice Address - Phone:904-389-5333
Practice Address - Fax:904-389-5332
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2024-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2016-01516207RH0005X, 207RN0300X
FLME160785207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207RH0005XAllopathic & Osteopathic PhysiciansInternal MedicineHypertension Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC19K9ROtherBCBS OF NC
NC1780003624Medicaid
NC19K9ROtherBCBS OF NC