Davis, Justin R
Davis, Justin R is an individual health care provider with primary practice located at 4015 22Nd Pl , Lubbock TX 79410-1119. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Davis, Justin R can be contacted via phone (806) 725-0030.Contact Information
Primary practice address
4015 22Nd Pl
Lubbock TX 79410-1119
Phone: (806) 725-0030
Fax: (806) 725-0015
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2012004798 | Missouri |
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 04-35493 | Kansas |
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 23806 | Mississippi |
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | R4957 | Texas |
Profile Details
NPI number | 1629282496 |
---|---|
LBN Legal business name | Davis, Justin R |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 10th, 2007 |
Last updated | Feb 14th, 2023 - about last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1629282496 | NPPES |
Mississippi | MEDICAID | 02683804 |
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