Provider Demographics
NPI:1346414943
Name:JOSEPH A DAVIS MD LLC
Entity Type:Organization
Organization Name:JOSEPH A DAVIS MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:478-475-8407
Mailing Address - Street 1:PO BOX 6957
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31208-6957
Mailing Address - Country:US
Mailing Address - Phone:478-475-8407
Mailing Address - Fax:
Practice Address - Street 1:306 ASHVILLE CT
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1669
Practice Address - Country:US
Practice Address - Phone:478-475-8407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty