| Christopher Davis Iii, | |
|
4102 Pinion Dr, Usaf Academy, CO 80840-2502 | |
| (719) 333-5041 | |
| Not Available |
| Full Name | Christopher Davis Iii |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant - Surgical |
| Location | 4102 Pinion Dr, Usaf Academy, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083096838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | (* (Not Available)) | Primary |
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |
| Entity Name | Poudre Valley Medical Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225356868 PECOS PAC ID: 9638208549 Enrollment ID: O20100602000122 |
| Mailing Address | Practice Location Address |
|---|---|
| Christopher Davis Iii, 340 Magnolia Cir, Tyndall Afb, FL 32403-5604 Ph: (850) 283-7491 | Christopher Davis Iii, 4102 Pinion Dr, Usaf Academy, CO 80840-2502 Ph: (719) 333-5041 |
Matthew Diotte, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4102 Pinion Dr, Usaf Academy, CO 80840 Phone: 719-333-5015 Fax: 719-333-1249 |
Kathryn Frances Hernandez, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 10th Medical Group, 4102 Pinion Drive, Usaf Academy, CO 80840 Phone: 719-333-5040 |
Tyler Clay, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4102 Pinion Dr, Usaf Academy, CO 80840 Phone: 719-333-5260 |
Johnny Elbert Davis Jr., PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4102 Pinion Dr, Usaf Academy, CO 80840 Phone: 719-333-5260 |
Mr. Francis Crosby Jr., PA-C MPAS Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4102 Pinon Drive, Usaf Academy, CO 80840 Phone: 719-333-5180 |
Jamie Virden, PHYSICIAN ASSISTANT Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4102 Pinion Dr, Usaf Academy, CO 80840 Phone: 210-556-8446 |
Mr. Matthew G Adkins, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4102 Pinion Dr, Usaf Academy, CO 80840 Phone: 719-333-6054 |