Provider Demographics
NPI:1215967542
Name:DAVIS ANESTHESIA ASSOCIATES, P.A.
Entity type:Organization
Organization Name:DAVIS ANESTHESIA ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:G
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:870-837-4065
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AR
Mailing Address - Zip Code:71711-0249
Mailing Address - Country:US
Mailing Address - Phone:870-837-4065
Mailing Address - Fax:870-836-1577
Practice Address - Street 1:638 CALIFORNIA AVE SW
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AR
Practice Address - Zip Code:71701-4604
Practice Address - Country:US
Practice Address - Phone:870-836-1215
Practice Address - Fax:870-836-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC00332251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management