MEDICARE: LAQUARDRA THOMAS-DAVIS

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1518800499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAQUARDRA THOMAS-DAVIS

Provider Business Mailing Address
First Line	:	3065 PEBBLE CREEK LN
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-7952
Country	:	US
Telephone Number	:	251-500-0241
Fax Number	:

Provider Business Practice Location Address
First Line	:	3065 PEBBLE CREEK LN
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-7952
Country	:	US
Telephone Number	:	251-500-0241
Fax Number	:

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

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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Directions to “ LAQUARDRA THOMAS-DAVIS ” Practice Location

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