Davis, Scott A

Davis, Scott A is an individual health care provider with primary practice located at 130 W Ravine Rd , Kingsport TN 37660-3837. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Davis, Scott A can be contacted via phone (423) 224-4000.

Contact Information

Primary practice address
130 W Ravine Rd Kingsport TN 37660-3837
Phone: (423) 224-4000
Fax: (423) 224-4746
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 10774 Tennessee

Profile Details

NPI number 1083609200
LBN Legal business name Davis, Scott A
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2005
Last updated May 8th, 2014 - about 11 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 1083609200 NPPES
Tennessee MEDICAID 100047850
Tennessee Other 4101127
Tennessee MEDICAID 74009465
Tennessee Other 00013859
Tennessee MEDICAID 010137276
Tennessee Other 175337
Tennessee Other TN0100
Tennessee MEDICAID 3634345

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