Provider Type Icon

DE' ANDRA DESTHEENIA DAVIS M.D. NPI 1225307184


NPI Information

NPI: 1225307184
Provider Name: DE' ANDRA DESTHEENIA DAVIS, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
504 HOPKINSVILLE ST
GREENVILLE, KY
ZIP 42345
Phone: (270) 338-6488
Get Directions

De' Andra Destheenia Davis, M.D. is a pediatrics in Greenville, KY. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. De' Andra Destheenia Davis, M.D. NPI is 1225307184. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

504 HOPKINSVILLE ST
GREENVILLE, KY
ZIP 42345-104
Phone: (270) 338-6488
Fax: (270) 338-7868

The enumeration date for this NPI number is 12/22/2011 and was last updated on 12/20/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics49716KENTUCKYYes
2208000000XPediatricsMD.205560LOUISIANANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17100444110MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.