Provider Demographics
NPI:1235278409
Name:DAVIS, LINDA C (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:C
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5570 DTC PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3187
Mailing Address - Country:US
Mailing Address - Phone:303-925-4960
Mailing Address - Fax:303-925-4961
Practice Address - Street 1:5570 DTC PKWY STE 200
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3187
Practice Address - Country:US
Practice Address - Phone:303-925-4960
Practice Address - Fax:303-925-4961
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34343207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01343433Medicaid
COCOA106050Medicare PIN
CO01343433Medicaid
G27886Medicare UPIN