Provider Demographics
NPI:1124080593
Name:DAVIDS, JON ROBERT (MD)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:ROBERT
Last Name:DAVIDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2425 STOCKTON BLVD.
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817
Mailing Address - Country:US
Mailing Address - Phone:916-453-2049
Mailing Address - Fax:916-453-2202
Practice Address - Street 1:2425 STOCKTON BLVD.
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-453-2049
Practice Address - Fax:916-453-2202
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG68422207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery