Healthcare Provider Details

I. General information

NPI: 1568054435
Provider Name (Legal Business Name): GAVIN STEVEN DAVIS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2021
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 FISHER ST RM 1A132
BILOXI MS
39534-2508
US

IV. Provider business mailing address

301 FISHER ST RM 1A132
BILOXI MS
39534-2508
US

V. Phone/Fax

Practice location:
  • Phone: 228-376-2273
  • Fax:
Mailing address:
  • Phone: 228-376-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number02007525A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number02007525A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: