Provider Demographics
NPI:1154528693
Name:DAVIS, DON ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:ALLEN
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2428 JENKS AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4304
Mailing Address - Country:US
Mailing Address - Phone:850-215-6008
Mailing Address - Fax:850-215-6020
Practice Address - Street 1:2428 JENKS AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4304
Practice Address - Country:US
Practice Address - Phone:850-215-6008
Practice Address - Fax:850-215-6020
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME120200207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002428300Medicaid
FL002428300Medicaid