Healthcare Provider Details

I. General information

NPI: 1265364756
Provider Name (Legal Business Name): FRANCISCO JAVIER GUZMAN DAVILA JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 GI MADDOX PKWY
CHATSWORTH GA
30705-2147
US

IV. Provider business mailing address

824 GI MADDOX PKWY
CHATSWORTH GA
30705-2147
US

V. Phone/Fax

Practice location:
  • Phone: 706-695-0561
  • Fax: 706-695-8678
Mailing address:
  • Phone: 706-695-0561
  • Fax: 706-695-8678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number14373
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: