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General NPI Number Information
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NPI Number | 1174798334
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Entity Type | Organization
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Legal Business Name | DON S DAVIS MD PA
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 5002 HWY 39 N BLDG A
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City | MERIDIAN
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State | MS
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Zip | 39301-1078
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Country | US
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Telephone | 601-485-8115
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Fax |
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Provider Business Mailing Address
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Address Line | 5002 HWY 39 N BLDG A
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City | MERIDIAN
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State | MS
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Zip | 39301-1078
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Country | US
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Telephone | 601-485-8115
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Fax |
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Authorized Official
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Title or Position | MD
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Name | DR. DON S DAVIS
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Credential | MD
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Telephone | 601-485-8115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 05257
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License Number State | MS
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