Davis, Larry
Davis, Larry is an individual health care provider with primary practice located at 6809 122Nd Ave , Kenosha WI 53142-7335. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Davis, Larry can be contacted via phone (262) 654-8633.Contact Information
Primary practice address
6809 122Nd Ave
Kenosha WI 53142-7335
Phone: (262) 654-8633
Fax: (262) 654-5467
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036-104343 | Illinois |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 69544-20 | Wisconsin |
Profile Details
| NPI number | 1699715888 |
|---|---|
| LBN Legal business name | Davis, Larry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 7th, 2006 |
| Last updated | Feb 1st, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699715888 | NPPES |
| Wisconsin | MEDICAID | 1699715888 | |
| Wisconsin | MEDICAID | 036104343 |
Popular Providers
-
Tahir, Zaigham U
6809 122Nd Ave , Kenosha WI 53142-7335 -
Sharih, Umair
4536 22Nd Ave , Kenosha WI 53140-5917 -
Sundareson, Ann Marie
6809 122Nd Ave , Kenosha WI 53142-7335 -
Iyer, Jaya V
6809 122Nd Ave , Kenosha WI 53142-7335 -
Quejada, Maria Estelita
6809 122Nd Ave , Kenosha WI 53142-7335 -
Ruffolo, Stefanie
6121 Green Bay Rd Ste 100 , Kenosha WI 53142-2931 -
Young, Gregory W
6809 122Nd Ave , Kenosha WI 53142-7335 -
Gerlach, Diane M
10400 75Th St , Kenosha WI 53142-8323