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General NPI Number Information
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NPI Number | 1801838859
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Entity Type | Individual
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Provider Name | DENNIS ALLAN DAVIS MD
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Gender | Male
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 143 KENNEDY DR
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City | MARTIN
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State | TN
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Zip | 38237-3309
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Country | US
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Telephone | 731-587-5321
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Fax | 731-588-3229
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Provider Business Mailing Address
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Address Line | 143 KENNEDY DR
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City | MARTIN
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State | TN
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Zip | 38237-3309
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Country | US
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Telephone | 731-587-5321
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Fax | 731-588-3229
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 28963
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 46558
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License Number State | TN
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