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KELLY VAN DAVIS M.D. NPI 1871554139


NPI Information

NPI: 1871554139
Provider Name: KELLY VAN DAVIS, M.D.
Classification: Internal Medicine - 207R00000X
Entity Type: Individual
Organization: WAGONER HOSPITAL AUTHORITY

PECOS Registration: Yes

Address:
10907 S KNOXVILLE AVE STE B
TULSA, OK
ZIP 74137
Phone: (918) 299-0323
Get Directions

Kelly Van Davis, M.D. is an internal medicine in Tulsa, OK with 21 years of experience. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. Kelly Van Davis, M.D. NPI is 1871554139. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduation Year:2003

The provider's business location address is:

10907 S KNOXVILLE AVE STE B
TULSA, OK
ZIP 74137-624
Phone: (918) 299-0323
Fax: (918) 299-0323

The NPI 1871554139 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/28/2006 and was last updated on 8/7/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine23418OKLAHOMAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17591838OTHEROKLAHOMAAETNA EDI #
2731297740OTHEROKLAHOMATAX ID #
3200077080AMEDICAIDOKLAHOMA

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: 11/14/2023

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.