Provider Demographics
NPI:1902812910
Name:DAVIS, DONNA C (DO)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:C
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 SUMMIT AVENUE
Mailing Address - Street 2:MSO PHYSICIAN BILLING
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:740-283-7597
Mailing Address - Fax:740-283-7807
Practice Address - Street 1:4100 JOHNSON RD STE 208
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2372
Practice Address - Country:US
Practice Address - Phone:740-314-5138
Practice Address - Fax:740-792-4171
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1380208100000X
OH34.0045942081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0113652000Medicaid
OH0735486Medicaid
OHP01160948OtherRAILROAD MEDICARE OHIO
OHH169521Medicare PIN
OHP01160948OtherRAILROAD MEDICARE OHIO
OHH169520Medicare UPIN
WV0113652000Medicaid