Provider Demographics
NPI:1083650303
Name:DAVIS, WILLIAM E (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2938
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-2938
Mailing Address - Country:US
Mailing Address - Phone:770-536-2146
Mailing Address - Fax:770-536-7895
Practice Address - Street 1:743 SPRING ST NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3715
Practice Address - Country:US
Practice Address - Phone:770-536-2146
Practice Address - Fax:770-536-7895
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA022741207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000397515EMedicaid
GA000397515FOtherMEDICAID URGENT CARE FRIENDSHIP
GA93BFDXXOtherMEDICARE URGENT CARE FRIENDSHIP
GA93BFDXXOtherMEDICARE URGENT CARE FRIENDSHIP
GA93BFBVQMedicare PIN