Active NPI
Darrell Davidson, M.D., PH.D.
- Clinical Pathology/Laboratory Medicine Physician
- Indianapolis, IN
National Provider Identifier
1346293552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician
- License
- 01036320A
- Practice address
- 635 Barnhill Dr
A128
Indianapolis, IN 46202-5126 - Phone
- (317) 274-4806
- NPI assigned
- May 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | 01036320A | IN | Primary |
Addresses
Primary practice location
635 Barnhill Dr
A128
Indianapolis, IN 46202-5126
Mailing address
635 Barnhill Dr
A128
Indianapolis, IN 46202-5126
Phone (317) 274-4806
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)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01036320A | IN | MD | Clinical Pathology/Laboratory Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473206400000",
"number": "1346293552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "635 BARNHILL DR",
"address_2": "A128",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025126",
"telephone_number": "317-274-4806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 BARNHILL DR",
"address_2": "A128",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025126",
"telephone_number": "317-274-4806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "DARRELL",
"credential": "M.D., PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-18",
"last_updated": "2016-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "IN",
"license": "01036320A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.