KENT MATTHEW DAVIS (NPI# 1548259179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548259179 |
| Entity Type | Individual |
| Full Name | KENT MATTHEW DAVIS |
| Credential | MD |
| Practice Address |
8288 S Broadway Ave Tyler TX 75703 |
| Mailing Address |
Po Box 846098 Dallas TX 75284-6098 |
| Practice Telephone | 9036067060 |
| Mailing Telephone | 9033246400 |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2018-11-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
H5863 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE RAIL ROAD | P02095992 | 01 |
| TX | 106108703 | 05 | |
| TX | MEDICARE | 709790 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8288 S Broadway Ave, Tyler, TX 75703 | 9036067060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881881969 | Kent F. Davis | Dentist | 2335 E Valley Pkwy Ste C, Escondido, CA 92027-2773 | 2007-10-02 |
| 1497953459 | Kent W. Davis | Otolaryngology | 3869 Canterbury Way, Idaho Falls, ID 83404-7971 | 2007-07-10 |
| 1225177710 | Kent L Davis | Family Medicine | 274 E Main St, Paris, KY 40361-2124 | 2007-02-05 |
| 1477644938 | Kent S. Davis | Obstetrics & Gynecology | 12303 Ne 130th Ln, #450, Kirkland, WA 98034-3099 | 2006-09-27 |
| 1699795666 | Kent Eston Davis | Dentist | 5100 Clayton Rd, Suite A 19, Concord, CA 94521-3139 | 2006-07-20 |
| 1568406387 | Kent Charles Davis | Psychiatry & Neurology | 1321 13th St N, St Cloud, MN 56303-2614 | 2006-06-15 |
| 1750341731 | Kent L Davis | Family Medicine | 2845 Bell St, Zanesville, OH 43701-1720 | 2006-03-24 |
| 1669452249 | Kent F Davis | Anesthesiology | 8000 E Maplewood Ave Ste 200, Greenwood Village, CO 80111-4727 | 2006-01-19 |
| 1972590644 | Kent Gregory Davis | Otolaryngology | 7900 Fannin St, Ste 1800, Houston, TX 77054-2952 | 2005-09-28 |
| Street Address |
8288 S BROADWAY AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376549246 | John Jason Page | Family Medicine | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2005-06-24 |
| 1427449529 | Sonja Faye Tiller | Nurse Practitioner | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2015-02-10 |
| 1669765350 | Mary Kathryn Eagleton | Pediatrics | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2011-05-27 |
| 1598993172 | Holly Akin Blanco | Pediatrics | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2009-06-23 |
| 1487893525 | Gale Jeannie Hobson | Family Medicine | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2009-02-12 |
| 1063661148 | Andrea M Ellis | Family Medicine | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2008-09-15 |
| 1235275314 | Kurt Nielsen | Emergency Medicine | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2007-01-29 |
| 1194743278 | Roy Brent Wadle | Family Medicine | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2006-07-17 |
| 1750344966 | Kimberly Eakin Wegener | Internal Medicine | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2006-04-10 |
| 1003881608 | John W Scroggins | Family Medicine | 8288 S Broadway Ave, Tyler, TX 75703-5262 | 2006-02-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073821807 | Frank P Reuter Jr Md Pa | Internal Medicine | 712 S Bois D Arc Ave, Tyler, TX 75701-1503 | 2010-09-14 |
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|---|---|---|---|---|
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| 1841830288 | Kennosa Kensha Gunn | Internal Medicine | 1300 Bay Area Blvd Ste 150, Houston, TX 77058-2505 | 2020-01-14 |
| 1679135420 | Pai Participant 9 Pa | Internal Medicine | 1550 Waters Ridge Dr, Lewisville, TX 75057-6011 | 2019-07-02 |
| 1972067718 | Primary & Palliative Home Care, Pllc | Internal Medicine | 8901 Emmett Lowry Expwy Suite A, Texas City, TX 77591 | 2019-01-25 |
| 1063986701 | Siddique Medical Associates Pllc | Internal Medicine | 2609 Webster Dr, Plano, TX 75075-6666 | 2019-01-16 |
| 1780198044 | Lucy E Quinn | Internal Medicine | 3910 Desert Springs Ln, Fulshear, TX 77441 | 2017-11-24 |
| 1457861411 | Apex House Calls, LLC | Internal Medicine | 5057 Keller Springs Rd Ste 300, Addison, TX 75001-6916 | 2017-10-04 |
| 1669994570 | Mina Health Services, LLC | Internal Medicine | 8811 Teel Pkwy Ste 100, Frisco, TX 75035-4201 | 2017-07-12 |
| 1679023410 | Siddique Medical Associates Pa | Internal Medicine | 1611 Bryce Canyon Ln, Allen, TX 75002-2696 | 2016-10-05 |
| Find all providers with the same taxonomy | ||||
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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.