Provider Demographics
NPI:1518493998
Name:DAVIS, JARED M (PA)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:M
Last Name:DAVIS
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Gender:M
Credentials:PA
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Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38302-0400
Mailing Address - Country:US
Mailing Address - Phone:731-425-5752
Mailing Address - Fax:731-422-5743
Practice Address - Street 1:2863 HIGHWAY 45 BYP
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3618
Practice Address - Country:US
Practice Address - Phone:731-664-1375
Practice Address - Fax:731-664-1378
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant