Provider Demographics
NPI:1396874723
Name:DAVIES, JEFFREY SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:DAVIES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:57 SIMSBURY LNDG
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-1437
Mailing Address - Country:US
Mailing Address - Phone:860-651-5971
Mailing Address - Fax:860-651-5971
Practice Address - Street 1:340 BROAD ST
Practice Address - Street 2:TOTAL MEDICAL CARE
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-3030
Practice Address - Country:US
Practice Address - Phone:860-688-8888
Practice Address - Fax:860-688-6381
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT029861207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT12105294OtherMULTIPLAN
CT320105OtherWELLCARE
CTPVN782046OtherAETNA HEALTHCARE
CT2760262OtherCIGNA
CT461110OtherCONNECTICARE
CT2V5742OtherHEALTHNET
CT2V5742OtherHEALTHNET