Healthcare Provider Details

I. General information

NPI: 1629906698
Provider Name (Legal Business Name): CHLOE ELIZABETH DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S MADISON ST
THOMASVILLE GA
31792-5473
US

IV. Provider business mailing address

927 HIWASSEE DAM ACCESS RD
MURPHY NC
28906-1846
US

V. Phone/Fax

Practice location:
  • Phone: 229-236-0831
  • Fax:
Mailing address:
  • Phone: 828-557-6872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13999
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: