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General NPI Number Information
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NPI Number | 1093951436
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Entity Type | Individual
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Provider Name | LUCY ELLEN DAVIDSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/06/2009
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | 1000 JOHNSON FY RD NE
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City | ATLANTA
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State | GA
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Zip | 30342-1611
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Country | US
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Telephone | 404-300-2741
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Fax | 404-250-7330
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Provider Business Mailing Address
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Address Line | 486 RIVER SOUND LN
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City | DAWSONVILLE
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State | GA
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Zip | 30534-0726
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Country | US
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Telephone | 404-556-0332
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 251119
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 24924
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License Number State | GA
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