Individual provider · NPI-1

Michael James Davidson, D.O.

Family Medicine · Lewisburg, TN

NPI number1740240902
StatusActive
Last updated in NPPESNov 14, 2012

Details

NPI
1740240902
Entity type
Individual (NPI-1)
Name
Michael James Davidson
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
Mar 23, 2006
Last updated
Nov 14, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineDO781TNYes

Practice location

1090 N Ellington Pkwy
Suite 102
Lewisburg, TN 37091-2227

Phone 913-359-0019 · Fax 931-359-7381

Mailing address

854 W James Campbell Blvd
Suite 303
Columbia, TN 38401-4659

Phone 931-359-0019 · Fax 931-359-7381

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