TULLY BOOTH DAVIS


Address: 705 Emerald Dr, Prattville, AL 36067-3711
Phone: 2052498551

TULLY BOOTH DAVIS (NPI# 1629676747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629676747
Entity Type Individual
Full Name TULLY BOOTH DAVIS
Practice Address 705 Emerald Dr
Prattville
AL 36067-3711
Practice Telephone 2052498551
Mailing Telephone 2052498551
Enumeration Date 2020-10-12
Last Update Date 2020-10-12
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Other Provider Identifier

State Issuer Identifier Type Code
BLUE CROSS BLUE SHIELD EIB901379535 01

Office Location

Street Address 705 EMERALD DR
City PRATTVILLE
State AL
Zip Code 36067-3711

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1316352552 Agape Me LLC Case Manager/Care Coordinator 353 Bent Tree Dr., Prattville, AL 36067 2014-06-26
1770868671 Susan Elizabeth Swink Pharmacist 703 South Memorial Dr, Walgreens Pharmacy, Prattville, AL 36067 2011-10-12
1255501458 Edwin R. Mullins Dentist 268 1st St., Prattville, AL 36067 2008-03-04
1598891046 James Ronald Roberson Sr. Dentist 113 E Main, Prattville, AL 36067 2007-02-26
1326184029 Prattville Primary Care LLC Family Medicine 461 E Main Street, Prattville, AL 36067 2007-01-29
1669591418 Walter Eugene Parker Family Medicine 107 Quail Run, Prattville, AL 36067 2007-03-29
1376582049 James Daniel Cartwright Internal Medicine 808 Durden Rd, Prattville, AL 36067-1533 2006-06-06
1386162816 Logan Elizabeth Dodd Speech-Language Pathologist 815 Durden Rd, Prattville, AL 36067-1534 2017-09-05
1891182200 Steve Weedon Specialist/Technologist 1218 Kingston Garden Rd, Prattville, AL 36067-1704 2015-04-23
1780042887 James K Nichols Jr. Nurse Anesthetist, Certified Registered 101 Coleman Dr, Prattville, AL 36067-1766 2016-02-03
Find all providers in zip 36067

Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154716066 Ashley Champion Student in an Organized Health Care Education/Training Program 199 Ridgewood Rd, Prattville, AL 36067-1913 2015-03-30

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1679170823 Terri Kast Student in an Organized Health Care Education/Training Program 2826 Moody Pkwy Ste A, Moody, AL 35004-3101 2020-10-01
1891302907 Dyneisha Barrett Student in an Organized Health Care Education/Training Program 2251 Liberty Ct, Mobile, AL 36608-9145 2020-09-23
1174135966 Amberlyn Nicole Baker Student in an Organized Health Care Education/Training Program 5370 Elgin Dr W, Grand Bay, AL 36541-3272 2020-08-21
1548872344 Shelby Glynn Student in an Organized Health Care Education/Training Program 1200 Somerby Dr Apt 326, Mobile, AL 36695-5429 2020-08-21
1407468689 Yasmeen Antheana-neshaygreen Brenson Student in an Organized Health Care Education/Training Program 206 Lakeview Ave, Selma, AL 36703-1705 2020-08-19
1366054496 Marc Simon Student in an Organized Health Care Education/Training Program 7866 Taylor Park Rd Apt G, Montgomery, AL 36117-4769 2020-08-19
1982216388 Kaitlyn Culotta Dozier Student in an Organized Health Care Education/Training Program 936 Grant Park Drive, Mobile, AL 36606 2020-08-18
1912518549 Makenzie Rose-lynn Dunning Student in an Organized Health Care Education/Training Program 2841 Leigh Ct, Mobile, AL 36695-9794 2020-08-17
1093326613 Rachael Lauren Abroms Student in an Organized Health Care Education/Training Program 871 W Briar Ct, Mobile, AL 36609-5167 2020-08-17
1669083275 Amedee Stokley Student in an Organized Health Care Education/Training Program 25 Lancaster Rd, Mobile, AL 36608-1903 2020-08-17
Find all providers with the same taxonomy

Competitor

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City PRATTVILLE
Zip Code 36067

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Dataset Information

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.

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