Douglas Frederick Davis, PH.D.
Individual provider Active NPI Psychologist · Las Vegas, NM
NPI 1891933883 · NPPES record last updated Jan 28, 2009
Key facts
- NPI
- 1891933883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 707 (NM)
- Practice address
- 3695 Hot Springs Blvd
Las Vegas, NM 87701-9549 - Phone
- (505) 454-2100
- Fax
- (505) 454-2130
- NPI assigned
- Jan 28, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 707 | NM | MD | Advanced Practice Midwife |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 707 | NM | Yes |
Addresses
Primary practice location
3695 Hot Springs Blvd
Las Vegas, NM 87701-9549
Mailing address
3695 Hot Springs Blvd
Las Vegas, NM 87701-9549
Phone (505) 454-2100
Other providers in Las Vegas, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.