Mary S David, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

MD0000012141 Issued in TN

Practice address

1755 Parr Ave
Dyersburg, TN 38024-2004

Phone

(731) 285-7311

Fax

(731) 285-2610

NPI assigned

Dec 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jackson Clinic PA

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1285629386
  NPD (past)
• Jackson Clinic PA

  • Durable Medical Equipment & Medical Supplies
  • Jackson, TN
  • NPI 1689443038
  NPD (past)

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1376527374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 PARR AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242004",
            "telephone_number": "731-285-7311",
            "fax_number": "731-285-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 PARR AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242004",
            "telephone_number": "731-285-7311",
            "fax_number": "731-285-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "MARY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-02",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TN",
            "license": "MD0000012141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerri B Cunningham
• Da Dove Transportation LLC
• Daniel Green MD
• Frances Leemary Daniels-Moses, LCSW
• Danny B Dedmon
• Vonda Leeann Davis, FNP
• Georgia Barnes Day, PTA
• Joel Allen Deal
• Delta Sleep Center PLLC
• Teri Dembinski, COTA/L

• Gynecology Physician in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Gynecology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; 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.