DR. WAYNE L. DAVIS (NPI# 1063459824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063459824 |
| Entity Type | Individual |
| Full Name | DR. WAYNE L. DAVIS |
| Credential | M.D. |
| Practice Address |
500 W Broadway St Missoula MT 59802-4003 |
| Mailing Address |
3205 S Russell St Missoula MT 59801-8536 |
| Practice Telephone | 4065437271 |
| Mailing Telephone | 4067214906 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2011-01-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
7721 | MT | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
7721 | MT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 0011466 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376716654 | Wayne Byron Davis | Chiropractor | 1715 5th Ave Ste A, Moline, IL 61265-7911 | 2008-04-08 |
| 1053490037 | Wayne J Davis | Technician/Technologist | 5061 S Mccarran Blvd, Reno, NV 89502-6530 | 2006-11-02 |
| 1245842954 | Wayne Davis | Technician | 1007 Mary St, Parkersburg, WV 26101-5223 | 2020-08-24 |
| 1073152583 | Wayne A Davis | Nursing Care | 301 Victoria St, Costa Mesa, CA 92627-7131 | 2019-12-31 |
| 1265663017 | Wayne Earl Davis | Ophthalmology | 3600 Amron Ct, Columbia, MO 65202-1918 | 2009-07-28 |
| 1063610293 | Wayne Albert Davis | Family Medicine | 3830 E Van Buren St, Phoenix, AZ 85008-6920 | 2007-07-10 |
| 1720109465 | Wayne M Davis | Dentist | 9733 Ustick Rd, Boise, ID 83704-5202 | 2007-04-02 |
| 1164599841 | Wayne Steven Davis | Podiatrist | 10918 Kingston Pike, Knoxville, TN 37934-2931 | 2006-11-29 |
| 1285743880 | Wayne P Davis | Internal Medicine | 2041 Georgia Ave Nw, Washington, DC 20060-0001 | 2006-08-29 |
| Street Address |
500 W BROADWAY ST |
| City | MISSOULA |
| State | MT |
| Zip Code | 59802-4003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982600359 | Kendra B. Lee | Family Medicine | 500 W Broadway St, Missoula, MT 59802-4008 | 2005-06-21 |
| 1205468725 | Stephanie Elizabeth Carl | Physician Assistant | 500 W Broadway St, Missoula, MT 59802-4008 | 2020-02-12 |
| 1942840483 | Credena Health LLC | Durable Medical Equipment & Medical Supplies | 500 W Broadway St, Missoula, MT 59802-4008 | 2020-01-13 |
| 1346880119 | Kaylyn Casebolt Desrosier | Pharmacist | 500 W Broadway St, Missoula, MT 59802-4008 | 2020-01-09 |
| 1689168049 | Kacia Bundle | Nurse Practitioner | 500 W Broadway St, Missoula, MT 59802-4008 | 2018-06-19 |
| 1114424488 | Hannah Gilliland | Nurse Practitioner | 500 W Broadway St, Missoula, MT 59802-4008 | 2018-04-12 |
| 1386164408 | Sandra Lynn Cummins | Social Worker | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-06-20 |
| 1548797152 | Joseph M Miller | Internal Medicine | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-05-12 |
| 1083147664 | Matthew Mcgady | Physician Assistant | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-04-10 |
| 1982135216 | Meeka Pradeep Gandhi | Pediatrics | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945921 | Montana Endoscopy Center, Pllc | Clinic/Center | 1930 W Broadway, Ste B, Missoula, MT 59802 | 2020-06-08 |
| 1194364091 | Tommie Lynn Perusich | Nurse Practitioner | 1120 Cedar St., Missoula, MT 59802 | 2019-12-26 |
| 1386122752 | The Hope Health Alliance, Inc. | Case Management | 314 White House Ln, Missoula, MT 59802 | 2018-07-30 |
| 1881181444 | Carol Anne Lesser | Massage Therapist | 1918 Birch St, Missoula, MT 59802 | 2018-04-19 |
| 1528587581 | Missoula Aids Fund, Inc. | Clinic/Center | 1500 W. Broadway Suite A, Missoula, MT 59802 | 2017-09-11 |
| 1942740667 | Gabrielle Shulman | Counselor | 415 N Higgins Ave Ste 14, Missoula, MT 59802 | 2017-02-28 |
| 1053798736 | Endurance Physio | Clinic/Center | 214 E. Main St, Missoula, MT 59802 | 2015-05-01 |
| 1720481971 | Anna Golding | Counselor | 1325 Wyoming Street, Missoula, MONTANA 59802 | 2014-10-02 |
| 1003255803 | Jennifer Dawn Danielson | Speech-Language Pathologist | 2408 Duncan Drive, Missoula, MT 59802 | 2013-06-14 |
| 1437595725 | Partnership Health Center Inc | Clinic/Center | 1150 Sherwood St, Missoula, MT 59802 | 2013-05-14 |
| Find all providers in zip 59802 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932739158 | Julie P Browne | Radiology | 2025 Eagle Nest Ln, Missoula, MT 59802-5796 | 2020-01-16 |
| 1265875991 | Tyson R Finlinson | Radiology | 2740 South Ave W, Missoula, MT 59804-5135 | 2013-04-11 |
| 1710278510 | Casey Schmitz | Radiology | 2419 Mullan Rd Ste D, Missoula, MT 59808-1856 | 2011-04-27 |
| 1891955027 | David Bauer | Radiology | 3819 Stephens Ave Ste 300, Missoula, MT 59801-8522 | 2008-06-11 |
| 1164533782 | Thomas Andrew Layne | Radiology | 414 Rainier Ct, Missoula, MT 59803-2456 | 2006-08-31 |
| 1205876992 | Daniel M Fruechte | Radiology | Advanced Imaging, 2803 South Ave W, Missoula, MT 59804 | 2006-06-08 |
| 1548250426 | Adam John Benson | Radiology | 3205 S Russell St, Missoula, MT 59801-8536 | 2005-10-24 |
| 1275081309 | Inland Imaging LLC - Mt | Radiology | 2419 Mullan Rd Ste D, Missoula, MT 59808-1856 | 2016-09-19 |
| 1053868992 | Integra Imaging Ps - Mt | Radiology | 2419 Mullan Rd, D, Missoula, MT 59808-1856 | 2016-09-08 |
| 1831538701 | Robert Frost | Radiology | 2740 South Ave W, Missoula, MT 59804 | 2013-06-24 |
| Find all providers in MISSOULA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.