Provider Demographics
NPI:1346401007
Name:DAVIS, ALETTE HOWARD (OD)
Entity Type:Individual
Prefix:DR
First Name:ALETTE
Middle Name:HOWARD
Last Name:DAVIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ALETTE
Other - Middle Name:
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:4761 ANDREW JACKSON PKWY STE 108
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1354
Mailing Address - Country:US
Mailing Address - Phone:901-857-5777
Mailing Address - Fax:
Practice Address - Street 1:4761 ANDREW JACKSON PKWY STE 108
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1354
Practice Address - Country:US
Practice Address - Phone:901-857-5777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT2817152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist