1295888204 NPI number — DR. FLORENCE HICKMAN DAVIDSON ED.D.

Table of content: DR. FLORENCE HICKMAN DAVIDSON ED.D. (NPI 1295888204)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295888204 NPI number — DR. FLORENCE HICKMAN DAVIDSON ED.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAVIDSON
Provider First Name:
FLORENCE
Provider Middle Name:
HICKMAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
ED.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HICKMAN
Provider Other First Name:
FLORENCE
Provider Other Middle Name:
BUNTING
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.A.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1295888204
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
457 ELM RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FALMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02540-2414
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-548-5560
Provider Business Mailing Address Fax Number:
508-548-5560

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
457 ELM RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FALMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02540-2414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-548-5560
Provider Business Practice Location Address Fax Number:
508-548-5560
Provider Enumeration Date:
01/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  1510 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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