Dr Jack Allen Davidson Jr, DDS, MD is a
Plastic Surgery based in Brandon, Florida. Dr Jack Allen Davidson Jr is licensed to practice in Florida (license number ME72794) and his current practice location is
1165 Nikki View Dr, Brandon, Florida. He can be reached at his office (for appointments etc.) via phone at
(813) 571-1516.
NPI number for Dr Jack Allen Davidson Jr is 1831289099 and his current mailing address is 1165 Nikki View Dr, Brandon, Florida. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1831289099.
Healthcare Provider's Profile
| Full Name | Dr Jack Allen Davidson Jr |
|---|
| Gender | Male |
|---|
| Speciality | Plastic Surgery |
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| Location | 1165 Nikki View Dr, Brandon, Florida |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1831289099
- Provider Enumeration Date: 10/16/2006
- Last Update Date: 04/14/2009
Medical Identifiers
Medical identifiers for Dr Jack Allen Davidson Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1831289099 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 10794 (Maryland) | Secondary |
| 208200000X | Plastic Surgery | ME72794 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack Allen Davidson Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Jack Allen Davidson Jr, DDS, MD
1165 Nikki View Dr,
Brandon, FL 33511-4879
Ph: (813) 571-1516 | Dr Jack Allen Davidson Jr, DDS, MD
1165 Nikki View Dr,
Brandon, FL 33511-4879
Ph: (813) 571-1516 |
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