MEDICARE: PHILIP V DAVIS NP

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
1	363LA2200X	Adult Health Nurse Practitioner	F311457-01	NY
2	363LA2200X	Adult Health Nurse Practitioner	APRN-NP209698	GA

General Provider Information

NPI Number	:	1285904383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP V DAVIS NP

Provider Business Mailing Address
First Line	:	2081 CLAIRMEADE VALLEY RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-1013
Country	:	US
Telephone Number	:	404-712-7109
Fax Number	:

Provider Business Practice Location Address
First Line	:	1364 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1059
Country	:	US
Telephone Number	:	404-712-7109
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2012
Last Update Date	:	03/03/2026

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