Provider Demographics
NPI:1033347273
Name:DAVIS, AMELIA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:AMELIA
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 E VIA DE VENTURA STE 202
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3325
Mailing Address - Country:US
Mailing Address - Phone:480-376-2227
Mailing Address - Fax:480-302-8646
Practice Address - Street 1:8600 E VIA DE VENTURA STE 202
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3325
Practice Address - Country:US
Practice Address - Phone:480-376-2227
Practice Address - Fax:845-302-8646
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1089702084P0800X
CAA1385362084P0800X
AZ503492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008991200Medicaid
FLHL278ZMedicare PIN