DR. THEODORE EDWIN CLYDE DAVIES (NPI# 1487656658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487656658 |
| Entity Type | Individual |
| Full Name | DR. THEODORE EDWIN CLYDE DAVIES |
| Credential | M.D. |
| Practice Address |
2603 Kentucky Ave Ste 404 Paducah KY 42003-3814 |
| Practice Telephone | 2704436472 |
| Practice Fax Number | 2704421649 |
| Mailing Telephone | 2704436472 |
| Mailing Fax Number | 2704421649 |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2008-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 16229 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | RAILROAD MEDICARE | P00391203 | 01 |
| KY | 64162290 | 05 |
| Street Address |
2603 KENTUCKY AVE STE 404 |
| City | PADUCAH |
| State | KY |
| Zip Code | 42003-3814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760873939 | Brandy Buckhalter | Nurse Practitioner | 2603 Kentucky Ave, Suite 105, Paducah, KY 42003-3814 | 2015-02-10 |
| 1699179895 | Baptist Health Medical Group Inc | Nurse Practitioner | 2603 Kentucky Ave, Suite 404, Paducah, KY 42003-3814 | 2014-10-17 |
| 1568862951 | Amy Knees | Nurse Practitioner | 2603 Kentucky Ave, Suite 301, Paducah, KY 42003-3814 | 2014-09-04 |
| 1932519766 | Chadwick Bassi | Podiatrist | 2603 Kentucky Ave, Suite 105, Paducah, KY 42003-3814 | 2014-05-01 |
| 1679998140 | Jonathan Gipson | Nurse Practitioner | 2603 Kentucky Ave, Suite 404, Paducah, KY 42003-3814 | 2014-02-20 |
| 1962832295 | Western Baptist Medical Ventures, Inc | Nurse Practitioner | 2603 Kentucky Ave, Suite 201, Paducah, KY 42003-3814 | 2013-11-22 |
| 1487924353 | Thomas James Gruber | Neurological Surgery | 2603 Kentucky Ave, Suite 404, Paducah, KY 42003-3814 | 2012-01-09 |
| 1013229368 | William Lee Titsworth | Neurological Surgery | 2603 Kentucky Ave, Suite 402, Paducah, KY 42003-3814 | 2010-07-01 |
| 1568699478 | Western Baptist Medical Ventures, Inc | Clinical Nurse Specialist | 2603 Kentucky Ave, Suite 304, Paducah, KY 42003-3814 | 2009-06-18 |
| 1467689844 | Griffin Keith Bicking | Surgery | 2603 Kentucky Ave, Suite 105, Paducah, KY 42003-3814 | 2009-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033757638 | Wilson Medical Staffing Pllc | Nurse Practitioner | 3130 Lone Oak Rd, Paducah, KY 42003 | 2019-12-13 |
| 1417415993 | Lauren Deanne Mcclain | Nurse Practitioner | 225 Medical Center Dr Ste 205, Paducah, KY 42003 | 2019-03-04 |
| 1871057042 | Brame Psychological Assessment Center | Psychologist | Ray and Kay Eckstein Outreach Center, 435 Berger Rd, Paducah, KY 42003 | 2019-01-22 |
| 1831611219 | Elizabeth Anne Wright | Social Worker | 425 Broadway Street, Paducah, KY 42003 | 2017-07-07 |
| 1558804724 | Kayla Reshea Franklin | Behavior Technician | 2075 Husband Road, Paducah, KY 42003 | 2016-11-21 |
| 1699189308 | Sunrise Children's Services, Inc. | Foster Care Agency | 3565 Lone Oak Rd Ste 2, Paducah, KY 42003 | 2014-06-20 |
| 1326488891 | Alice Ann Higdon Wilham | Surgery | 1532 Lone Oak Rd Ste 235, Paducah, KY 42003 | 2013-06-28 |
| 1881924611 | Meghan Ashley Lee | Nurse Practitioner | 1532 Lone Oak Rd Ste 245, Paducah, KY 42003 | 2009-12-29 |
| 1174771018 | Sleep Source Kentucky, LLC | Clinic/Center | 3125 Parisa Drive, Paducah, KY 42003 | 2008-09-04 |
| 1851547426 | Zandra Bristol Farley | Registered Nurse | 1532 Lone Oak Road Suite 445, Lourdes Marshall Nemer Pavillion, Paducah, KY 42003 | 2008-08-14 |
| Find all providers in zip 42003 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356519508 | Mercy Health Partners - Lourdes Hospital | Neurological Surgery | 1530 Lone Oak Rd., Suite 345, Paducah, KY 42003 | 2008-02-11 |
| 1154311736 | Robert Preston Meriwether | Neurological Surgery | 4625 Falconcrest Drive, Suite A, Paducah, KY 42001-7458 | 2005-10-25 |
| 1548250129 | Sean P Mcdonald | Neurological Surgery | 2725 James Sanders Blvd, Ste A, Paducah, KY 42001-8405 | 2005-10-25 |
| 1487924353 | Thomas James Gruber | Neurological Surgery | 2603 Kentucky Ave, Suite 404, Paducah, KY 42003-3814 | 2012-01-09 |
| 1013229368 | William Lee Titsworth | Neurological Surgery | 2603 Kentucky Ave, Suite 402, Paducah, KY 42003-3814 | 2010-07-01 |
| 1689808107 | Jonathan Darrell Couch | Neurological Surgery | 1532 Lone Oak Rd, Suite 143, Paducah, KY 42003-7913 | 2009-05-12 |
| 1477503597 | Allan C Gocio | Neurological Surgery | 225 Medical Center Dr, Suite 401, Paducah, KY 42003-7914 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952768384 | Mohamed Maher Hulou | Neurological Surgery | 800 Rose Street Ukmc Department of Neurosurgery Ms 110, Lexington, KY 40536 | 2016-01-15 |
| 1689081895 | Brian Neil Snyder | Neurological Surgery | 800 Rose Street Ms 101, Lexington, KY 40536-0001 | 2014-07-20 |
| 1902240013 | William Lewis Dillen | Neurological Surgery | 800 Rose Street, Ms101, Lexington, KY 40536-0298 | 2013-04-18 |
| 1578819108 | Farhan Arshad Mirza | Neurological Surgery | 800 Rose St # Ms 101, Lexington, KY 40536-0298 | 2012-08-01 |
| 1144584095 | Justin David Hilliard | Neurological Surgery | 740 S Limestone Ky Clinic 401, Lexington, KY 40536 | 2012-06-26 |
| 1952696676 | Nessa S Timoney | Neurological Surgery | 825 2nd Ave Ste C3, Bowling Green, KY 42101-1791 | 2011-06-10 |
| 1124267125 | William E Pearson | Neurological Surgery | 9454 Parks Rd, Utica, KY 42376-9574 | 2009-02-13 |
| 1851542195 | Injury-care Associates and Chiropractic Center of Ky LLC | Neurological Surgery | 3955 Dixie Hwy, Louisville, KY 40216-4166 | 2008-10-06 |
| 1932384930 | Tann A Nichols | Neurological Surgery | 544 Centre View Blvd, Crestview Hills, KY 41017-3400 | 2008-01-08 |
| 1811189715 | James S Powell, Md Psc | Neurological Surgery | 617 23rd St Ste 15, Ashland, KY 41101-2845 | 2007-08-14 |
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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.