Davis, Keith L

Davis, Keith L is an individual health care provider with primary practice located at 600 W 3Rd St , Mansfield OH 44906-2633. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Davis, Keith L can be contacted via phone (141) 952-2619.

Contact Information

Primary practice address
600 W 3Rd St Mansfield OH 44906-2633
Phone: (141) 952-2619
Fax: (419) 525-6723
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35052285 Ohio

Profile Details

NPI number 1952488215
LBN Legal business name Davis, Keith L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated May 14th, 2021 - about 3 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 1952488215 NPPES
Ohio MEDICAID 0658891

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