Provider Demographics
NPI:1871607036
Name:DAVIS, AMY F (PA)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:F
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 950248
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0248
Mailing Address - Country:US
Mailing Address - Phone:502-489-5730
Mailing Address - Fax:502-489-5753
Practice Address - Street 1:10216 TAYLORSVILLE RD
Practice Address - Street 2:SUITE #400
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-3616
Practice Address - Country:US
Practice Address - Phone:502-267-5456
Practice Address - Fax:502-267-5488
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2020-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KYPA209363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50032128OtherPASSPORT
KY000000708714OtherANTHEM
KYK030390Medicare PIN
KY000000708714OtherANTHEM