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Justin Davis
Plastic and Reconstructive Surgery Physician in Springfield, Illinois
NPI 1437714375

Justin Davis is a Plastic and Reconstructive Surgery Physician based in Springfield, IL and is specialized in Plastic and Reconstructive Surgery. Justin Davis practices in Springfield, IL. The NPI Number for Justin Davis is 1437714375 and holds a License No. (Illinois).

The current practice location address for Justin Davis is 747 N Rutledge St, Springfield, IL and can be reached out via phone at 217-545-6112. You can also correspond with Justin Davis through the mailing address at PO BOX 19653, SPRINGFIELD, IL - 62794-9653 (mailing address contact number: 217-545-2588).

Location: 747 N Rutledge St, Springfield, IL, 62794-9653
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1437714375
Provider Name
Justin Davis
Credential
Provider Entity Type
Individual
Gender
Male
Address
747 N Rutledge St, Springfield, IL, 62794-9653
Phone Number
217-545-6112
Fax Number
Provider Enumeration Date
05/06/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
747 N Rutledge St
City
Springfield
State
Illinois
Zip
62702-6700
Phone Number
217-545-6112
Fax Number
person
Provider Business Mailing Address Details
Address
Po Box 19653
City
Springfield
State
Illinois
Zip
62794-9653
Phone Number
217-545-2588
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Plastic and Reconstructive Surgery
Taxonomy
2086S0122X
License No.
125.077838 (Illinois)
Definition
A surgeon who specializes in plastic and reconstructive surgery.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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