Davis, Ked L
Davis, Ked L is an sole proprietor health care provider with primary practice located at 1701 E North St , Magnolia AR 71753-3204. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Davis, Ked L can be contacted via phone (870) 234-3802.Contact Information
Primary practice address
1701 E North St
Magnolia AR 71753-3204
Phone: (870) 234-3802
Fax: (870) 234-7386
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | AR-E-5314 | Arkansas |
Profile Details
| NPI number | 1699981894 |
|---|---|
| LBN Legal business name | Davis, Ked L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 15th, 2007 |
| Last updated | May 21st, 2024 - about 7 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699981894 | NPPES |
| Arkansas | MEDICAID | 167832001 |
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