Provider Demographics
NPI:1205328804
Name:DAVIS, JAMES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:DAVIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4857 RACCOON RD
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:MO
Mailing Address - Zip Code:64844-7474
Mailing Address - Country:US
Mailing Address - Phone:417-385-1999
Mailing Address - Fax:
Practice Address - Street 1:1711 CHEROKEE AVE
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:MO
Practice Address - Zip Code:64865-8681
Practice Address - Country:US
Practice Address - Phone:417-776-8701
Practice Address - Fax:417-776-3974
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014027753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist