Provider Demographics
NPI:1285960112
Name:DAVIS, RICHARD FLOYD
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:FLOYD
Last Name:DAVIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 14TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-6956
Mailing Address - Country:US
Mailing Address - Phone:541-704-2703
Mailing Address - Fax:541-928-1817
Practice Address - Street 1:2700 14TH AVE SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-6956
Practice Address - Country:US
Practice Address - Phone:541-704-2703
Practice Address - Fax:541-928-1817
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P-10124809237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist