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NPI Code Detail

MEDICARE: JOHN BOWEN DAVIS

MEDICARE: JOHN BOWEN 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
1390200000XStudent in an Organized Health Care Education/Training Program
2208M00000XHospitalist Physician96213GA

General Provider Information

NPI Number : 1861029746
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN BOWEN DAVIS
Provider Business Mailing Address
First Line : 49 JESSE HILL JR DR SE
Second Line :
City : ATLANTA
State : GA
Zip : 30303-3049
Country : US
Telephone Number : 404-778-7777
Fax Number :
Provider Business Practice Location Address
First Line : 49 JESSE HILL JR DR SE
Second Line :
City : ATLANTA
State : GA
Zip : 30303-3049
Country : US
Telephone Number : 404-778-7777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2020
Last Update Date : 05/27/2026

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