MEDICARE: DR. ALAN 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
1	207X00000X	Orthopaedic Surgery Physician	030745	GA
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	030745	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831199207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN D DAVIS M.D.

Provider Business Mailing Address
First Line	:	900 CIRCLE 75 PKWY SE
Second Line	:	SUITE 1700
City	:	ATLANTA
State	:	GA
Zip	:	30339-3035
Country	:	US
Telephone Number	:	770-953-6929
Fax Number	:	770-953-6972

Provider Business Practice Location Address
First Line	:	1265 HIGHWAY 54 W
Second Line	:	SUITE 102
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214-4548
Country	:	US
Telephone Number	:	770-460-1900
Fax Number	:	770-714-1214

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	06/03/2014

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Directions to “ DR. ALAN D DAVIS M.D.” Practice Location

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