Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DAVIN RAY MODISETTE
ActiveDAVIN RAY MODISETTE is a Radiologic Technologist healthcare provider located in JACKSON, Tennessee. NPI 1356721245 is currently active in the NPPES registry. Verify at CMS.
Radiologic Technologist · JACKSON, TN
Registration Details
- NPI Number
- 1356721245
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 4, 2015 (11.206025083062 yrs)
- Last Updated
- Dec 28, 2022
- License
-
487010 (TN)
Practice Information
- Address
-
23 WESTHAVEN PLJACKSON, TN, 383051758Browse TN providers · Browse ZIP 38305
- Phone
- 3184750690
- Fax
- 7314353385
- Primary Specialty
-
Radiologic Technologist
247100000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.