Provider Demographics
NPI:1942203963
Name:DAVIS, STACY FAITH (MD)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:FAITH
Last Name:DAVIS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:4230 HARDING PIKE STE 900
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-4900
Practice Address - Country:US
Practice Address - Phone:615-964-5841
Practice Address - Fax:615-250-4100
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27614174400000X, 207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1510069Medicaid
TN3097373Medicaid
TN6012044OtherBCBS
TNP01376946OtherRR MEDICARE
TN3097373Medicaid
TN1510069Medicaid
TN1510069Medicaid