Provider Demographics
NPI:1467656728
Name:REAMES, DAVIS L (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVIS
Middle Name:L
Last Name:REAMES
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 1:4 JACKSON BLVD.
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405
Mailing Address - Country:US
Mailing Address - Phone:912-355-1010
Mailing Address - Fax:912-503-2983
Practice Address - Street 1:4 JACKSON BLVD.
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405
Practice Address - Country:US
Practice Address - Phone:912-355-1010
Practice Address - Fax:912-721-3092
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA072096207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003148357AMedicaid
GA003148357AMedicaid