Davis, Larry J.

Davis, Larry J. is an individual health care provider with primary practice located at 1025 Maine St , Quincy IL 62301-4038. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Davis, Larry J. can be contacted via phone (217) 222-6550.

Contact Information

Primary practice address
1025 Maine St Quincy IL 62301-4038
Phone: (217) 222-6550
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036069511 Illinois

Profile Details

NPI number 1164495347
LBN Legal business name Davis, Larry J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Nov 14th, 2008 - about 16 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 1164495347 NPPES
Illinois MEDICAID 036069511

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