Provider Demographics
NPI:1548006695
Name:KENT L DAVIS MD
Entity type:Organization
Organization Name:KENT L DAVIS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-987-6230
Mailing Address - Street 1:274 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-2124
Mailing Address - Country:US
Mailing Address - Phone:859-987-6230
Mailing Address - Fax:859-987-0149
Practice Address - Street 1:274 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2124
Practice Address - Country:US
Practice Address - Phone:859-987-6230
Practice Address - Fax:859-987-0149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health