Provider Demographics
NPI:1851315154
Name:DAVIS, BARBARA RUTH (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:RUTH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9568 MEETING ST
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-8300
Mailing Address - Country:US
Mailing Address - Phone:317-695-6878
Mailing Address - Fax:317-863-1052
Practice Address - Street 1:911 E 86TH ST STE 108
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-4002
Practice Address - Country:US
Practice Address - Phone:317-756-9896
Practice Address - Fax:317-863-1052
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039457A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000313263OtherANTHEM
IN100217470Medicaid
IN100217470Medicaid
INF42472Medicare UPIN