Individual provider Active NPI

Bobby Dean Davidson, PHARM. D.

  • Pharmacist
  • Little Rock, AR
National Provider Identifier
1013128669
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6558 Issued in AR
Practice address
23325 McAnich Rd
Little Rock, AR 72210-5239
Phone
(501) 821-1644
Fax
(501) 664-1244
NPI assigned
May 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6558 AR Primary

Addresses

Primary practice location

23325 McAnich Rd
Little Rock, AR 72210-5239

Mailing address

23325 McAnich Rd
Little Rock, AR 72210-5239
Phone (501) 821-1644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
6558ARMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013128669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23325 MCANICH RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722105239",
            "telephone_number": "501-821-1644",
            "fax_number": "501-664-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23325 MCANICH RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722105239",
            "telephone_number": "501-821-1644",
            "fax_number": "501-664-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "BOBBY",
        "middle_name": "DEAN",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "6558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.