Dr. Jesse Thornhill Davidson III, M.D.
Specialist in Roanoke, VA. Individual provider (NPI-1).
NPI number1801891791
StatusActive
Last updated in NPPESJan 22, 2014
Details
- NPI
- 1801891791
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jesse Thornhill Davidson III
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 16, 2005
- Last updated
- Jan 22, 2014
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 0101034302 | VA | Yes |
Practice location
1234 Franklin Rd SwRoanoke, VA 24016-4606
Phone 540-283-6071 · Fax 540-283-6098
Mailing address
1234 Franklin Rd SwRoanoke, VA 24016-4606
Phone 540-345-1561 · Fax 540-345-2112
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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