| Davis Health & Wellness Clinic, P.c. | |
|
808 Speciality Dr Ste A Dexter MO 63841-2753 | |
| (573) 891-1250 | |
| (573) 891-1320 |
| Full Name | Davis Health & Wellness Clinic, P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 808 Speciality Dr Ste A, Dexter, Missouri |
| Authorized Official Name and Position | Bradford Joseph Davis (OWNER/PROVIDER) |
| Authorized Official Contact | 5738911250 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Davis Health & Wellness Clinic, P.c. Po Box 603 Dexter MO 63841-0603 Ph: (573) 891-1250 | Davis Health & Wellness Clinic, P.c. 808 Speciality Dr Ste A Dexter MO 63841-2753 Ph: (573) 891-1250 |
| NPI Number | 1154066561 |
|---|---|
| Provider Enumeration Date | 04/29/2022 |
| Last Update Date | 04/29/2022 |
| Medicare PECOS PAC ID | 6608248448 |
|---|---|
| Medicare Enrollment ID | O20230204000423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154066561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Bradford J Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184002842 PECOS PAC ID: 0446332316 Enrollment ID: I20160303002532 |
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