Michael L Davis M.D., P.a.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

08327 Issued in MS

Legal business name

MICHAEL L DAVIS M.D., P.A.

Practice address

2100 Highway 61 N
Vicksburg, MS 39183-8211

Phone

(601) 630-9755

NPI assigned

Sep 23, 2008

Last updated

Jan 27, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Lee Davis, M.D.NPI 1033147442

Title

M.D./President

Phone

(601) 630-9755

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael L Davis, MD

  • Nephrology Physician
  • Vicksburg, MS
  • NPI 1033147442
  Authorized official Same address or phone

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1891945234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838211",
            "telephone_number": "601-630-9755",
            "fax_number": "601-630-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838211",
            "telephone_number": "601-630-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L DAVIS M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "M.D./PRESIDENT",
        "authorized_official_telephone_number": "601-630-9755",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "08327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09455302",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1319422",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medically Heard LLC
• Maegan H Meeks, RN
• Harold Melancon, LPC
• Cesar Luis Merino, M.D.
• Larry J. Meyers, MD
• Amanda Miller
• Lameka Q Miller, FNP
• Karyn Milly
• Alys Minckler, OT
• Mind. Body. Spirit. LLC

• Nephrology Physician in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Nephrology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.