Active NPI
Lasan Davis, MD
- Family Medicine Physician
- Tuskegee, AL
National Provider Identifier
1790726867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 13059
- Practice address
- 203 West Lee Street
Tuskegee, AL 36083 - Phone
- (334) 727-7050
- Fax
- (334) 727-6284
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
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.
-
- Primary Care Clinic/Center
- Birmingham, AL
- NPI 1669429080
-
- Psychiatric Hospital
- Tuscaloosa, AL
- NPI 1437295409
-
- Psychiatric Hospital
- Mt Vernon, AL
- NPI 1427066307
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13059 | AL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Alabama Dept of Finance | Past | Accepting new patients | |
| State of Alabama Dept of Finace | Past | Accepting new patients | |
| American Family Care, LLC | Past | Accepting new patients |
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 13059 | AL | Primary |
Addresses
Primary practice location
203 West Lee Street
Tuskegee, AL 36083
Mailing address
203 West Lee St
Tuskegee, AL 36083
Phone (334) 727-7050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51524383 | Other | AL | BLUE CROSS BLUE SHIELD |
Other names 1
- Lasan Davis
NPI Registry JSON
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207526400000",
"number": "1790726867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "203 WEST LEE ST",
"city": "TUSKEGEE",
"state": "AL",
"postal_code": "36083",
"telephone_number": "334-727-7050",
"fax_number": "334-727-6284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 WEST LEE STREET",
"city": "TUSKEGEE",
"state": "AL",
"postal_code": "36083",
"telephone_number": "334-727-7050",
"fax_number": "334-727-6284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LASAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2008-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "13059",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "51524383",
"state": "AL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LASAN",
"last_name": "DAVIS",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Tuskegee, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.