Healthcare Provider Details

I. General information

NPI: 1477487593
Provider Name (Legal Business Name): MR. LIONEL DAVIS JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6736 W LAVERNE ST
NEW ORLEANS LA
70126-2507
US

IV. Provider business mailing address

6736 W LAVERNE ST
NEW ORLEANS LA
70126-2507
US

V. Phone/Fax

Practice location:
  • Phone: 504-274-7129
  • Fax:
Mailing address:
  • Phone: 504-274-7129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WV0202X
TaxonomyVehicle Modifications Contractor
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: