MEDICARE: GEORGE R. DAVIS DO

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	207Q00000X	Family Medicine Physician	OS5749	FL

General Provider Information

NPI Number	:	1740229558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE R. DAVIS DO

Provider Business Mailing Address
First Line	:	38135 MARKET SQ
Second Line	:
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33542-7505
Country	:	US
Telephone Number	:	813-528-4975
Fax Number	:

Provider Business Practice Location Address
First Line	:	13311 N 56TH ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617-1161
Country	:	US
Telephone Number	:	813-899-2015
Fax Number	:	813-980-2700

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	08/25/2021

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