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NPI Code Detail

MEDICARE: WOODY D. DAVIS M.D.

MEDICARE:   WOODY D. DAVIS  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist05260MS

Other Identifiers

General Provider Information

NPI Number : 1154423804
Entity Type Code : Individual
Provider Name (Legal Business Name) : WOODY D. DAVIS M.D.
Provider Business Mailing Address
First Line : 408 WINDOVER CIR
Second Line :
City : MERIDIAN
State : MS
Zip : 39305-2023
Country : US
Telephone Number : 601-483-4338
Fax Number :
Provider Business Practice Location Address
First Line : 5002 HIGHWAY 39 N
Second Line : BLDG. B
City : MERIDIAN
State : MS
Zip : 39301-1078
Country : US
Telephone Number : 601-483-7331
Fax Number : 601-483-3721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2006
Last Update Date : 07/08/2007

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Directions to “ WOODY D. DAVIS M.D.” Practice Location

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