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General NPI Number Information
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NPI Number | 1538674650
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Entity Type | Individual
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Provider Name | CARLA PERRY-DAVIS
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Gender | Female
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Dates
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Enumeration Date | 12/12/2017
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 200 E PONCE DE LEON AVE STE 110
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City | DECATUR
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State | GA
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Zip | 30030-3467
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Country | US
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Telephone | 404-501-6374
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Fax |
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Provider Business Mailing Address
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Address Line | 325 HAMILTON PARK DR
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City | ROSWELL
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State | GA
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Zip | 30075-5500
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Country | US
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Telephone | 470-350-3881
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 8574
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License Number State | GA
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