Keith E Davis

NPI #1972673218 in Shoshone, Idaho

Provider Information

NPI Number: 1972673218
Entity Type: Organization
Organization Name: Keith E Davis
Primary Specialty: Clinic/Center - Rural Health
Enumeration Date: Nov 8, 2006
Last Updated: Mar 8, 2012

Practice Location

Address: 113 S APPLE ST
City: Shoshone
State: Idaho
ZIP Code: 83352-5287
Phone: (208) 886-2222

Authorized Official

Name: KEITH E DAVIS, MD
Title: OWNER
Phone: (208) 886-2224

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rural Health — Rural Health	261QR1300X	Primary

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