John Howard Davidson, PA

Physician Assistant · Carbondale, IL

Individual Active NPI

NPI number 1043480056

Practice location

405 W Jackson St
Carbondale, IL 62901-1462

Phone: (618) 549-0721
Fax: (618) 457-0469

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NPI record

NPI: 1043480056
Entity type: Individual (Type 1)
Enumeration date: March 5, 2008
Last updated: January 11, 2021
Certified: January 11, 2021
Sole proprietor: No

Specialties & taxonomy codes

Taxonomy	Code	License	State
Physician Assistant Primary	`363A00000X`	085001572	IL
Physician Assistant	`363A00000X`	—	—

Mailing address

16091 Swingley Ridge Rd
Suite #100
Chesterfield, MO 63017-2056

Phone: (636) 728-2200

Other practice locations (3)

16091 Swingley Ridge Rd, Suite #100, Chesterfield, MO 63017-2056 · (636) 728-2200
201 S 14th St, Herrin, IL 62948-3631 · (618) 942-2171
2 S Hospital Dr, Murphysboro, IL 62966-3333 · (618) 684-3156

About John Davidson

John Howard Davidson, PA is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 405 W Jackson St, Carbondale, IL 62901-1462. The NPI number 1043480056 was assigned on March 5, 2008 and the record was last updated on January 11, 2021.

John Davidson lists a license in the registry: #085001572 (IL) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of John Howard Davidson, PA?

The NPI number is 1043480056.

What is the phone number of John Davidson?

The phone number listed for the practice location is (618) 549-0721.

Where is John Davidson located?

405 W Jackson St, Carbondale, IL 62901-1462.

What is the taxonomy code for John Davidson?

The primary taxonomy code is 363A00000X – Physician Assistant; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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