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Mr. Douglas Joel Davidson
Optician in Moscow, Idaho
NPI 1770672842

Douglas Joel Davidson is a Optician based in Moscow, ID and is specialized in Optician. Douglas Joel Davidson practices in Moscow, ID. The NPI Number for Douglas Joel Davidson is 1770672842 and holds a License No. DO00000689 (Idaho).

The current practice location address for Douglas Joel Davidson is 512 S Main St, Moscow, ID and can be reached out via phone at 208-883-3000.

Location: 512 S Main St, Moscow, ID, 83843-2918
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770672842
Provider Name
Douglas Joel Davidson
Credential
Provider Entity Type
Individual
Gender
Male
Address
512 S Main St, Moscow, ID, 83843-2918
Phone Number
208-883-3000
Fax Number
Provider Enumeration Date
10/12/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
512 S Main St
City
Moscow
State
Idaho
Zip
83843-2918
Phone Number
208-883-3000
Fax Number
person
Provider Business Mailing Address Details
Address
512 S Main St
City
Moscow
State
Idaho
Zip
83843-2918
Phone Number
208-883-3000
Fax Number
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
DO00000689 (Washington)
Definition
Definition to come...
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