Provider Demographics
NPI:1568566123
Name:DAVISON, ROBERT D
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:DAVISON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4772
Mailing Address - Country:US
Mailing Address - Phone:781-229-6333
Mailing Address - Fax:781-229-6335
Practice Address - Street 1:1 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4772
Practice Address - Country:US
Practice Address - Phone:781-229-6333
Practice Address - Fax:781-229-6335
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2079111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U45682Medicare UPIN
Y45602Medicare ID - Type Unspecified