Davis, Bruce Anthony

Davis, Bruce Anthony is an individual health care provider with primary practice located at 9905 Shelbyville Rd , Louisville KY 40223-2907. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Davis, Bruce Anthony can be contacted via phone (502) 425-5166.

Contact Information

Primary practice address
9905 Shelbyville Rd Louisville KY 40223-2907
Phone: (502) 425-5166
Fax: (502) 327-0526
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 18190 Kentucky
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 18190 Kentucky

Profile Details

NPI number 1205821600
LBN Legal business name Davis, Bruce Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2005
Last updated Sep 13th, 2017 - about 7 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 1205821600 NPPES
Kentucky MEDICAID 64181902

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