Davidson, Philip A

Davidson, Philip A is an individual health care provider with primary practice located at 2200 Park Ave Bldg D Ste 100, Park City UT 84060-7246. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Davidson, Philip A can be contacted via phone (435) 615-8822.

Contact Information

Primary practice address
2200 Park Ave Bldg D Ste 100 Park City UT 84060-7246
Fax: (435) 615-8823
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X ME54865 Florida

Profile Details

NPI number 1528040367
LBN Legal business name Davidson, Philip A
Credentials MEDICAL DOCTOR
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Oct 1st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528040367 NPPES
Florida Other 2000016351 RAILROAD MEDICARE
Florida Other 4511587 RAILROAD MEDICARE
Florida Other AVMED RAILROAD MEDICARE
Florida Other 18987 RAILROAD MEDICARE
Florida MEDICAID 373524900 RAILROAD MEDICARE

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