MEDICARE: CATHERINE D DAVIS PA/AA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367H00000X	Anesthesiologist Assistant	002988	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	P00422622	OTHER	GA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P00097133	OTHER	GA	PALMETTO GBA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	580628385	OTHER	GA	TRICARE
7	391018	OTHER	GA	WELLCARE

General Provider Information

NPI Number	:	1306814249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE D DAVIS PA/AA

Provider Business Mailing Address
First Line	:	624 BELLGROVE PT
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31220-7621
Country	:	US
Telephone Number	:	478-731-4009
Fax Number	:

Provider Business Practice Location Address
First Line	:	624 BELLGROVE PT
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31220-7621
Country	:	US
Telephone Number	:	478-731-4009
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	12/10/2014

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Directions to “ CATHERINE D DAVIS PA/AA” Practice Location

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