Individual ProviderRichard Lee DavisFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address4470 Valley St, Enola, PA 17025-1443(717) 732-8883(717) 761-0208PECOS EnrollmentBased on the most recent information from CMS, provider Richard Lee Davis does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1679533665Provider TypeIndividualFull NameDavis, Richard LeeCredentialMDGenderMaleSole ProprietorNoEnumeration Date3/24/2006Last Updated8/18/2009Contact InformationPractice LocationPractice Address4470 Valley St, Enola, PA 17025-1443Phone(717) 732-8883Fax(717) 732-1640Mailing LocationMailing Address3 Walnut St, Suite 206, Lemoyne, PA 17043-1168Phone(717) 761-0208Fax(717) 761-2023Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseMD032778EPennsylvaniaProvider IdentifiersIDDescriptionIssuerID068548DescriptionMedicaidIssuerUnlistedPennsylvania